Ear infection (middle ear), symptoms, causes, most important dangerous factors


An ear infection (sometimes called acute otitis media) is an infection of the middle ear, the air-filled space behind the eardrum that contains the small, vibrating bones of the ear. Children are more likely than adults to get ear infections.

Ear infection (middle ear), symptoms, causes, most important dangerous factors

Because ear infections often go away on their own, treatment may begin with pain control and monitoring for the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to getting multiple ear infections. This can cause hearing problems and other serious complications.

Symptoms of otitis media

The signs and symptoms of an ear infection usually develop quickly.

Middle ear infection in children

Common signs and symptoms in children include:

  • Earache, especially when lying down
  • Pulling or pulling the ear
  • sleep problems
  • Crying more than usual
  • playfulness
  • Difficulty hearing or responding to sounds
  • loss of balance
  • Fever of 100 F (38 C) or higher
  • fluid draining from the ear
  • Headache
  • Anorexia

Otitis media in adults

Common signs and symptoms in adults include:

  • ear pain
  • fluid draining from the ear
  • Hearing problem

When to see a doctor when otitis media

Ear infection signs and symptoms can indicate several conditions. It is important to get an accurate diagnosis and prompt treatment. Call your child's doctor if:

  • Symptoms persist for more than a day
  • Symptoms appear in a child under 6 months of age
  • severe ear pain
  • Your baby or toddler is restless or irritable after a cold or other upper respiratory infection
  • You notice fluid, pus, or blood coming out of the ear

Causes of otitis media

An ear infection is caused by a bacteria or virus in the middle ear. This infection often results from another illness — a cold, the flu, or an allergy — that causes congestion and swelling in the nasal passages, throat, and eustachian tubes.

The role of the eustachian tubes

The Eustachian tubes are a pair of narrow tubes that run from each middle ear to the top of the back of the throat, behind the nasal passages. The throat end of the tubes opens and closes to:

  • Regulating air pressure in the middle ear
  • Freshens the air in the ear
  • Drainage of normal secretions from the middle ear
  • The swollen Eustachian tubes can become blocked, causing fluid to build up in the middle ear. This fluid can become infected and cause symptoms of an ear infection.

In children, the eustachian tubes are narrower and more horizontal, making their drainage more difficult and more prone to blockage.

The role of the adenoids

The adenoids are two small pads of tissue at the back of the nose that are thought to play a role in immune system activity.

Since the adenoids are near the opening of the Eustachian tubes, the swelling of the adenoids can block the tubes. This can lead to otitis media. Swollen and irritated adenoids are more likely to play a role in ear infections in children because children have relatively larger adenoids compared to adults.

Related cases of middle ear infection

Middle ear conditions that may be linked to an ear infection or lead to similar problems in the middle ear include:

  1. Otitis media with effusion, or swelling, and fluid buildup (effusion) in the middle ear without a bacterial or viral infection. This may occur because fluid buildup continues after the ear infection has improved. It may also be caused by some dysfunction or noninfectious blockage of the eustachian tubes.
  2. Chronic otitis media with effusion occurs when fluid remains in the middle ear and keeps coming back without a bacterial or viral infection. This makes children vulnerable to new ear infections and may affect hearing.
  3. Chronic suppurative otitis media, an ear infection that does not go away with usual treatments. This can lead to a perforation of the eardrum.

Risk factors for middle ear infection

Risk factors for an ear infection include:

  1. Age Babies between the ages of 6 months and 2 years are more likely to get ear infections because of the size and shape of the eustachian tubes and because their immune systems are still developing.
  2. Group child care. Children who are cared for in group settings are more likely to get colds and ear infections than children who are kept at home. Children in pediatric groups are exposed to more infections, such as the common cold.
  3. Infant feeding. Babies who drink from a bottle, especially while lying down, tend to get ear infections more often than breastfed babies.
  4. seasonal factors. Ear infections are most common during the fall and winter months. People with seasonal allergies may be more likely to get ear infections when pollen counts are high.
  5. The air quality is poor. Exposure to tobacco smoke or high levels of air pollution can increase your risk of developing an ear infection.
  6. Alaskan Native Heritage. Ear infections are more common among Alaskan Natives.
  7. Cleft palate. Differences in bone and muscle structure in children with a cleft palate may make it difficult to drain the Eustachian tube.

Complications of otitis media

Most ear infections do not cause long-term complications. Repeated ear infections can lead to serious infections


  1. Hearing impairment. Mild hearing loss that comes and goes is fairly common with ear infections but usually gets better after the infection clears. Repeated ear infections, or fluid in the middle ear, may lead to more serious hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur.
  2. Speech or developmental delays. If a hearing is temporarily or permanently impaired in infants and young children, they may experience delays in speech and social and developmental skills.
  3. Spread of infection. An infection or infection that does not respond well to treatment can spread to nearby tissues. Mastoiditis, the bony bump behind the ear, is called mastoiditis. This infection can damage the bones and form pus-filled cysts. Serious middle ear infections rarely spread to other tissues in the skull, including the brain or the membranes surrounding the brain (meningitis).
  4. ruptured eardrum; Most eardrum tears heal within 72 hours. In some cases, surgical repair is required.

Prevention of middle ear infection

The following tips may reduce your risk of developing an ear infection:

  1. Prevent colds and other diseases. Teach your children to wash their hands frequently and thoroughly and not to share eating and drinking utensils. Teach your children to cough or sneeze into their elbow. If possible, limit the time your child spends in group childcare. Setting up child care may help with fewer children. Try to keep your child at home away from childcare or school when they are sick.
  2. Avoid passive smoking. Make sure no one smokes in your home. Far from home, stay in smoke-free environments.
  3. Feed your baby. If possible, breastfeed your baby for at least six months. Breast milk contains antibodies that may protect against ear infections.
  4. If you are bottle-feeding your baby, hold your baby upright. Avoid putting the bottle in your baby's mouth when he is lying down. Do not put bottles in bed with your child.
  5. Talk to your doctor about vaccinations. Ask your doctor about the appropriate vaccinations for your child. Seasonal flu shots, pneumococcal vaccines, and other bacterial vaccines may help prevent ear infections.

My Video Middle Ear Infection (Acute Otitis Media) | Causes, Symptoms, Diagnosis, Treatment

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