Ear Infection (Otitis Media)

What is an infection of the middle ear?

The term “ear infection” usually refers to an infection of the middle ear. The middle ear is the space behind the eardrum. Anyone can get an ear infection, but ear infections are more common in children less than 8 years old.

The medical term for a middle ear infection is otitis media.

What is the cause?

Ear infections usually start with a viral infection of the nose and throat. For example, a cold might lead to an infection of the ear. Ear infections may also occur when you have allergies. The viral infection or allergic reaction can cause swelling of the tube between your ear and throat (the Eustachian tube). The swelling may trap bacteria in your middle ear, resulting in a bacterial infection.

Pressure from the buildup of pus or fluid in the ear sometimes causes the eardrum to tear (rupture). The eardrum is a thin membrane that separates and protects the delicate parts of the middle ear from the air, moisture, and earwax in the ear canal.

What are the symptoms?

You may have one or more of these symptoms:

• earache
• hearing loss
• feeling of blockage in the ear
• fever
• dizziness

How is it diagnosed?

Your healthcare provider will ask about your symptoms and look at your eardrum.

Your healthcare provider may use a special light to look into the ear canal and check for fluid in the ear. Your provider will look at how the eardrum moves when a puff of air is blown into the ear. If there is fluid behind the eardrum, the membrane will not move well.

How is it treated?

Antibiotic medicine is a common treatment for ear infections. However, recent studies have shown that the symptoms of ear infections often go away in a couple of days without antibiotics. Bacteria can become resistant to antibiotics, and the medicine may cause side effects. For these reasons, your healthcare provider may wait 1 to 3 days to see if the symptoms go away on their own before prescribing an antibiotic.

Your provider may recommend a decongestant (tablets or a nasal spray) to help clear the Eustachian tube. This may help relieve pressure in the middle ear.

For pain take a nonprescription pain reliever such as acetaminophen or ibuprofen. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

How long will the effects last?

In most cases you should feel better in 2 to 3 days.

If you are taking an antibiotic and your eardrum has not returned to normal when your provider examines you again, you may need to take a different antibiotic or other medicine. In this case, it may take another 1 to 2 weeks before your ear feels normal again.

What can I do to take care of myself?

• Follow your healthcare provider's instructions.
• If you are taking an antibiotic, take all of it according to the directions, even when the symptoms have gone away before you have finished it.
• To help relieve pain, put a warm moist washcloth or a hot water bottle over the ear.
• If you have discharge from your ear, you can wipe it away with a washcloth and loosely plug the ear with cotton to catch further drainage. Discharge from the ear can mean that you have an infection of the ear canal or, if you have a lot of fluid and pus draining from your ear, you may have a ruptured eardrum. Ask your healthcare provider how to care for the ear if you have discharge. If the discharge is caused by a ruptured eardrum, then you will need to protect the ear from water. You will need one or more follow-up appointments to check the healing of your eardrum.
• If you have a fever:
  • Rest until your temperature has fallen below 100°F (37.8°C). Then become as active as is comfortable.
  • Ask your provider if you can take aspirin, acetaminophen, or ibuprofen to control your fever.
  • Keep a daily record of your temperature.
• Call your healthcare provider if you have:
  • a temperature of 101.5 degrees F (38.6 degrees C) or higher that does not go away even after you take acetaminophen, aspirin, or ibuprofen
  • a severe headache or worsening pain around the ear
  • swelling around the ear
  • increasing dizziness
  • worsening of hearing problems
  • weakness of one side of your face.
• Keep all your appointments. Your healthcare provider may want you to have one or more follow-up exams until signs of inflammation and infection have disappeared.

How can I prevent an ear infection from occurring?

• If you tend to get ear infections often, ask your healthcare provider if you need to be checked for allergies. Getting treatment for allergies may help prevent ear infections.
• Ask if using decongestants when you have a cold may help prevent you from getting ear infections.