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Ear infection (middle ear): Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors , Complications , Prevention

What is Ear Infection (middle ear)?

An ear infection is an infection of the middle ear. It is common in children and usually occurs due to a cold or other respiratory infection.

Managing pain and monitoring the problem may help to clear an ear infection on its own. Sometimes antibiotics are used to kill the infection. Some people are more likely to get ear infections than others. This can lead to hearing problems, as well as other serious complications.

What is Ear Infection (middle ear)

Explanation of medical terms and concept Ear infection (middle ear)

The normally used term “ear infection” is understood medically as acute otitis or a sudden infection within the cavity (the area behind the eardrum). Anyone will get an ear infection — youngsters in addition as adults — though ear infections are one in every of the foremost common reasons why young children visit aid suppliers

In several cases, ear infections clearly informed their own. Your healthcare provider could advocate a medicine to alleviate pain. If the ear infection has worsened or not improved, your healthcare provider may inflict an antibiotic. In children younger than the age of 2 years, associate antibiotic is typically required for ear infections.

It’s necessary to examine your aid supplier to see if the ear infection has recovered or if you or your kid has current pain or discomfort. Hearing issues and different serious effects will occur with ongoing ear infections, frequent infections and once fluid builds up behind the eardrum.

An ear infection is a type of inflammation of the middle ear The middle ear is located behind the eardrum Infections can be caused by bacteria and viruses including common cold or influenza viruses; or fungi such as yeast Symptoms include pain in the ear fullness and drainage from one or both ears Treatment often includes antibiotics; a decongestant may also be used to treat pain Some people with recurrent infections may benefit from surgery to improve drainage of fluid from the middle ear.

in adults Most ear infections in adults are caused by bacteria which may be spread from one person to another through coughing or sneezing Bacteria also can get into the middle ear through the Eustachian tube (which is connected to the back of the nose) and travel down to an eardrum that has become immobile Some people who have chronic ear infections have a history of allergies or asthma Certain health conditions — such as diabetes heart failure and liver problems — can increase your risk for developing an ear infection.

Symptoms Ear infection (middle ear)

The onset of symptoms for ear infection usually occurs quickly.

The main symptoms include:

  • earache

  • a high temperature (fever)

  • being sick

  • a lack of energy

  • slight hearing loss - if the middle ear becomes filled with fluid

In some cases, a hole might develop within the tissue layer (perforated eardrum) and pus may run out of the ear. The earache, that is caused by the build-up of fluid stretching the eardrum, then resolves.


Some common signs and symptoms in children include:

  • Ear pain, especially when lying down

  • Tugging or pulling at an ear

  • Trouble sleeping

  • Crying more than usual

  • Fussiness

  • Trouble hearing or responding to sounds

  • Loss of balance

  • Fever of 100 F (38 C) or higher

  • Drainage of fluid from the ear

  • Headache

  • Loss of appetite


Some common signs and symptoms in adults include:

  • Ear pain

  • Drainage of fluid from the ear

  • Trouble hearing

When to see a doctor

If you are noticing any signs or symptoms of an ear infection, be sure to see your child's doctor for an accurate diagnosis and prompt treatment. If you feel like your child has an ear infection, call their doctor immediately.

  • Symptoms last for more than a day

  • The symptoms of jaundice usually appear in a child less than 6 months old.

  • Ear pain is severe

  • Your infant or toddler is sick and not sleeping or being cooperative after getting a cold or other respiratory infection.

  • If you see a discharge of fluid from your ear, it means there is an infection.

Causes Ear infection (middle ear)

An ear infection is caused when a bacterium or virus infects the middle ear. This infection often happens as a result of another illness, such as a cold virus or an allergy.

The middle ear will become infected once the slim tube (called the auditory tube) that connects it to the rear of the nose stops operating properly. The Eustachian tube keeps gas pressure from increasing and drains fluid from the center ear. A chilly or allergic reaction can cause the liner of the nose, throat and eustachian tube to swell and become congested. microorganisms and viruses can grow when fluid becomes cornered inside.

Young kids are additional seemingly than adults to urge ear infections as a result of their eustachian tubes being shorter, narrower and horizontal. This makes it easier for bacteria to urge in associated tougher for fluid to drain. Also, young kids have weaker immune systems, creating it harder for them to repulse infection.

whereas anyone could develop an ear infection, a baby is additional seemingly to get one if he or she:

  • Has a family history of ear infections

  • Has a poor immune system

  • Is around someone who smokes/air pollution

  • Spends time in a daycare setting

  • Is bottle-fed instead of breastfed or pacifier use

  • Drinks from a bottle while laying on his or her back

Role of eustachian tubes

The eustachian tubes are a pair of small tubes that run from each middle ear to high in the back of the throat behind the nasal passages. The throat end of the tubes opens and closes to allow saliva, mucus, and other materials to flow out of the ears.

  • Regulate air pressure in the middle ear

  • Refresh air in the ear

  • Empty the middle ear of normal secretions.

If the eustachian tubes become swollen, they may be blocked, which can lead to fluids building up in the middle ear. This fluid can become infected and cause an ear infection.

Children have narrower and more horizontal eustachian tubes, making it more difficult to drain them and more likely for them to get clogged.

Role of adenoids

Adenoids are two small, tissue-rich sacs located high on the back of the nose. Some people believe they have a role in the immune system.

If you have adenoids, they may swell and block your eustachian tubes. This can lead to a middle ear infection. The swelling and irritation of your adenoids is more likely to cause an ear infection in children because children have larger adenoids than adults. For adults, this is not a toy.

Related conditions

If there are conditions in the middle ear that may be related to an ear infection, or if the middle ear problems are similar, these conditions may include:

  • Otitis media with effusion,If there is an accumulation of fluid (swelling and effusion) in the middle ear, this may not be caused by a bacterial or viral infection. It may persist even after an infection has cleared up, due to some dysfunction or obstruction of the eustachian tubes.

  • Chronic otitis media with effusion,If fluid remains in the middle ear, this is called otitis media. Children are more likely to get new ear infections if this happens, and it may affect their hearing.

  • Chronic suppurative otitis media,A Ear Infection that Doesn't Go Away. If an ear infection doesn't go away with the usual treatments, this can lead to a hole in the eardrum.

Risk factors Ear infection (middle ear)

Risk factors for ear infections include:

  • Age.Children between the ages of 6 months and 2 years are more susceptible to ear infections because their eustachian tubes are smaller and their immune systems are still developing.

  • Group child care.Children who are cared for in groups are more likely to get colds and ear infections than children who stay home. The children in group settings are exposed to more viruses, such as the common cold, which can be harmful to them.

  • Infant feeding.Babies who drink from a bottle are more likely to get ear infections than babies who are breast-fed.

  • Seasonal factors.Ear infections are most common during the fall and winter seasons. People with seasonal allergies may be at a greater risk of ear infections when pollen counts are high.

  • Poor air quality.Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infections. Ear infections can be caused by exposure to tobacco smoke or high levels of air pollution.

  • Alaska Native heritage.Alaska Native children are more likely to get ear infections.

  • Cleft palate.Children who have cleft palates may have different bone and muscle structures, which may make it more difficult for the eustachian tube to function properly.


Most ear infections don't cause long-term problems. Occasional ear infections can lead to more serious complications, such as hearing loss or infection in other parts of the body.

  • Impaired hearing. Mild hearing loss that comes and goes is common with an ear infection. Ear infections that happen again or fluid in the middle ear can lead to more significant hearing loss. If there is any permanent damage to the eardrum, then hearing loss may be more serious. Permanent hearing loss may occur if other middle ear structures are damaged.

  • Speech or developmental delays.If someone's hearing is temporarily or permanently impaired in infants and toddlers, they may experience delayed speech social and developmental skills.

  • Spread of infection. If an infection is not treated, it can spread to nearby tissues. Mastoiditis is an infection of the mastoid bone, which is a bony protrusion in the back of your head. This can lead to bone damage and the formation of cysts filled with pus. Rarely, this infection can be quite serious. Ear infections can spread to other tissues in the skull, including the brain or the membranes that surround the brain (meningitis).

  • Tearing of the eardrum.Most eardrum tears heal within a few days. In some cases surgery is needed to repair the tear.


Some tips to reduce the risk of developing ear infections include:

  • Protect yourself from colds and other illnesses.Teach your children to wash their hands often and thoroughly, and not to share eating and drinking utensils. Teach your children how to cough or sneeze into their elbows in case they get sick. If possible, try to keep your child at home when they are in group care. A setting with fewer children may help.If your child is home from school or child care when they are ill, that is okay.

  • Avoid secondhand smoke.Make sure that no one smokes in your home. And if you have to be away from home, try to stay in smoke-free environments.

  • Breast-feed your baby.If you can, breastfeed your baby for at least six months. Breast milk contains antibodies that may protect against ear infections.

  • If you are bottle-feeding your baby, hold them in an upright position.Do not prop a bottle in your baby's mouth while he or she is lying down. Do not put bottles in the crib with your baby.

  • Talk to your doctor about vaccinations.Talk to your doctor about which vaccinations are appropriate for your child. Some seasonal flu shots can help prevent ear infections. Pneumococcal and other bacterial vaccines may help prevent pneumonia.

Diagnosis Ear infection (middle ear)

Your doctor can usually diagnose a condition based on your symptoms and an exam. The doctor may use a lighted instrument to look inside your ears, throat, and nasal passage. He or she may also listen to your child's breathing. A stethoscope is a medical device that resembles a small bell and is used to listen to the sounds made by the body.

Your tending supplier can inspect your or your child’s ear employing an instrument known as AN otoscope. A healthy membrane is going to be chromatic gray in color and clear (clear). If infection is present, the eardrum is also inflamed, swollen or red.

Your healthcare provider can also check the fluid within the tympanic cavity victimization, a gas otoscope, that blows a little quantity of air at the eardrum. This could cause the eardrum to maneuver back and forth. The eardrum won't move as simply if there's fluid within the ear.

Another test, tympanometry, uses gas pressure to see for fluid within the middle ear. This check doesn’t test hearing. If needed, your tending supplier can order a hearing test, performed by AN audiologist, to see potential deafness if you or your kid has had long lasting or frequent ear infections or fluid in the middle ears that's not draining.

Pneumatic otoscope

An otoscope called a pneumatic is often the only specialized tool a doctor needs to diagnose an ear infection. This instrument enables the doctor to see if there is fluid behind the eardrum. With the pneumatic otoscope, the doctor gently blows air against the ear. The eardrum normally moves when air is pushed into the ear. If fluid has collected in the middle ear, your doctor may not be able to see the eardrum moving.

Additional tests

In case of doubt, your doctor may do other tests in order to make a more definite diagnosis. If the condition hasn't improved after previous treatments or if there are other long-term problems, your doctor may do additional tests.

  • Tympanometry.This test measures how the eardrum moves when sound waves hit it. A device that seals off the ear canal adjusts air pressure, which causes the eardrum to move. The device then measures how well the eardrum moves and provides an indirect measure of pressure within the middle ear.

  • Acoustic reflectometry.This test measures how much sound is reflected back from the eardrum. This is an indirect measure of fluid levels in the middle ear. Normally, the eardrum absorbs most of the sound. However, as pressure in the middle ear increases, the eardrum will reflect more sound.

  • Tympanocentesis.A doctor may use a tiny tube to drain fluid from the middle ear. The fluid is tested for viruses and bacteria. This can help if an infection has not responded well to previous treatments.

  • Other tests.If your child has had multiple ear infections or fluid buildup in the middle ear, their doctor may refer them to a hearing specialist (audiologist), speech therapist, or developmental therapist for tests of hearing, speech skills, language comprehension, or developmental abilities.

What a diagnosis means

  • Acute otitis media.The diagnosis of ear infection is a way of referring to acute otitis media. Your doctor may make this diagnosis if they see signs or symptoms of an infection and if symptoms started suddenly.

  • Otitis media with effusion means fluid in the middle ear.If the doctor finds fluid in the ear during an otitis media examination, this means that there is no infection present.

  • Chronic suppurative otitis media.If the doctor suspects that you have chronic suppurative otitis media, they will find that your ear infection caused the tearing of the eardrum. This often happens because pus drains from the ear.

Treatment Ear infection (middle ear)

Treatment of ear infections depends on age, severity of the infection, the character of the infection (is the infection a first-time infection, current infection or continuation infection) associated degreed if fluid remains within the bodily cavity for an extended amount of time.

Your attention supplier can suggest medications to alleviate you or your child’s pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider could value it more highly to wait some days to check if the infection goes away on its own before prescribing an antibiotic.

Some ear infections will resolve without the use of antibiotics. This will vary based on your child's age and the severity of symptoms.

A wait-and-see approach

Most ear infections clear up on their own within a couple of days, without any treatment. The American Academy of Pediatrics and the American Academy of Family Physicians recommend waiting to see if the infection goes away on its own before doing anything.

  • Children between the ages of 6 and 23 months who have mild middle ear pain in one ear for less than 48 hours and a temperature below 102.2 degrees Fahrenheit (39 degrees Celsius) are okay.

  • Children 24 months and older who have mild middle ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F (39 C) are not contagious and do not require antibiotics.

Some people believe that treating children with ear infections with antibiotics might be helpful. However, using antibiotics too often can lead to the development of bacteria that are resistant to the medicine. Talk to your doctor about whether or not antibiotics are a good idea for you and your child.

Managing pain

Your doctor will give you advice on treatments to lessen pain from an ear infection. These may include the following:

  • Pain medication. Your doctor may recommend the use of over-the-counter painkillers like Tylenol or Advil. Use them as directed on the label, and be careful when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu are more likely to develop Reye's syndrome if they take aspirin. Do not take aspirin if you are experiencing any symptoms, as it has been linked to Reye's Syndrome. Talk to your doctor if you have any concerns.

  • Anesthetic drops.These can be used to relieve pain if the eardrum does not have a hole or tear.

Antibiotic therapy

If your doctor observes an ear infection, he may prescribe antibiotics in the following situations:

  • Children 6 months and older with moderate to severe ear pain in one or both ears for at least 48 hours, or a temperature of 102.2 degrees Fahrenheit (39 degrees Celsius) or higher

  • Children 6 to 23 months who have mild middle ear pain and a temperature less than 102.2 degrees Fahrenheit (39 degrees Celsius) within 48 hours are ok.

  • Children 24 months and older who are experiencing mild middle ear pain in one or both ears for less than 48 hours and a temperature below 102.2 Fahrenheit (39 Celsius) are okay to go back to school.

Children younger than 6 months of age with confirmed acute otitis media are more likely to be treated with antibiotics without waiting for observation.

After the symptoms have improved, be sure to take the antibiotic as directed. Missing a dose can lead to recurring infection and resistance of bacteria to antibiotics. Talk with your doctor or pharmacist about what to do if you accidentally miss a dose.

Ear tubes

If your child has certain conditions, like repeated ear infections or fluid buildup after an infection has cleared up, your doctor may recommend a procedure to drain fluid from the middle ear. A doctor may suggest this procedure for a child's health.

During an outpatient surgery called a myringotomy, a surgeon makes a small hole in the eardrum. This allows them to remove fluids from the middle ear. A tiny tube (tympanostomy tube) is inserted to help ventilate the middle ear and prevent more fluid from accumulating. Some tubes are meant to stay in place for a few months or up to a year, while others may need to be surgically removed.

After the ear tube is removed, the eardrum usually returns to its normal size.

There is a treatment for chronic suppurative otitis media.

Chronic suppurative otitis media is a difficult infection to treat. It is often treated with antibiotics that are given as drops. You may be instructed on how to suction fluids out of the ear canal before treatment begins. Giving drops.


If your child has frequent infections or fluid in the middle ear, you will need to be monitored closely. Talk to your doctor about how often you should schedule follow-up appointments. Your doctor may recommend regular hearing and language tests.

Making sure you are ready for your appointment.

If the problem has not resolved on its own or is occurring frequently, you may be referred to a doctor who specializes in ear, nose, and throat (ENT) disorders.

If your child is old enough to answer questions, talk to them beforehand and be prepared to answer any questions on their behalf. Questions for adults will be about the same issues.

  • What signs or symptoms have you noticed?

  • When did the symptoms begin?

  • Does the person have ear pain? What would you say is the severity of the pain?

  • Are you noticing any signs that your infant or toddler is in pain, such as difficulty sleeping or unusual irritability?

  • Has your child had a fever?

  • Does the discharge from the ear look clear, cloudy, or bloody?

  • Does your child have difficulty hearing? Does your older child ask you repeated questions when there is noise around them?

  • Has your child recently had a cold or other respiratory infection?

  • Does your child have seasonal allergies?

  • Has your child had an ear infection in the past? When was the last time this happened?

  • Does your child have any allergies to medications such as amoxicillin?

General summary

How do I know if my middle ear is infected?

If you are experiencing any of the following symptoms you may have an ear infection: Pain in your ears (particularly when chewing or swallowing) Feeling of fullness in your ears after swimming or flying or when taking a shower or bath (may indicate fluid buildup) Excessive cleaning of your ears with cotton swabs which can injure the delicate skin inside the ear and push bacteria further into the ear canal You should clean your outer ear with soap and water but never insert anything into your eardrum Not only is this painful it will cause damage to the inner ear Only a physician should clean the inner part of your ear If you.

Can a middle ear infection be treated at home?

Yes a middle ear infection can be treated at home It is important that the infection is treated early to prevent it from spreading to other parts of the body and turning into a serious illness When you have a middle ear infection it is best to keep your child home from school or daycare until he or she has been diagnosed and started on treatment.

How do you get rid of middle ear fluid naturally?

The first thing to try is a simple home remedy that can relieve the pressure in your ear You can use a few drops of warm olive oil and massage it into your ear Simply tilt your head to one side while you gently massage the oil into the outer ear After letting this sit for about 10 minutes lay back down with your head flat on a pillow and let gravity help drain any fluid out of your ear Or if you have ever had swimmer's ear you know how horrible it is when water gets trapped in there and just won't come out Well rubbing alcohol works almost instantly for that! Just put a couple drops in each affected ear let.

ear infection middle ear treatment

Ear pain itching or discharge can signal an ear infection Other symptoms might include fever and irritability If your child is 2 years old or younger watch for signs of ear infection in both ears such as pulling at the ear and unsteady balance Call the doctor if these symptoms appear.

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Ear infection (middle ear): Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors  , Complications , Prevention

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