Middle Ear Infection – A cold, allergies, or a sinus infection can block the tubes in your middle ear. When fluid builds up and gets infected, your doctor will call it otitis media, This is the most common cause of ear pain. If your doctor thinks the cause is a bacteria, she may prescribe antibiotics.
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What is the main reason for ear pain?
Ear injury from pressure changes (from high altitudes and other causes) Object stuck in the ear or buildup of ear wax. Hole in the eardrum. Sinus infection.
How long should an earache last?
Check if it’s an ear infection – The symptoms of an ear infection usually start quickly and include:
- pain inside the ear
- a high temperature
- being sick
- a lack of energy
- difficulty hearing
- discharge running out of the ear
- a feeling of pressure or fullness inside the ear
- itching and irritation in and around the ear
- scaly skin in and around the ear
Young children and babies with an ear infection may also:
- rub or pull their ear
- not react to some sounds
- be irritable or restless
- be off their food
- keep losing their balance
Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week. If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better. Differences between inner, middle and outer ear infections
| Inner ear infection | Middle ear infection (otitis media) | Outer ear infection (otitis externa) |
|---|---|---|
| Can affect both children and adults | Usually affects children | Usually affects adults aged 45 to 75 |
| Caused by viral or bacterial infections | Caused by viruses like colds and flu | Caused by something irritating the ear canal, such as eczema, water or wearing earplugs |
| Affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis | Affects the eustachian tube, which connects the middle ear (area behind the eardrum) to the back of the nose | Affects the ear canal (the tube between the outer ear and the eardrum) |
Which medicine is best for ear pain?
Managing pain – Your doctor will advise you on treatments to lessen pain from an ear infection. These may include the following:
Pain medication. Your doctor may advise the use of over-the-counter acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) to relieve pain. Use the drugs as directed on the label. Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin because aspirin has been linked with Reye’s syndrome. Talk to your doctor if you have concerns. Anesthetic drops. These may be used to relieve pain if the eardrum doesn’t have a hole or tear in it.
What causes ear pain but no infection?
Earaches can happen without an infection. They can occur when air and fluid build up behind the eardrum. They may cause a feeling of fullness and discomfort. They may also impair hearing.
Which disease symptoms is ear pain?
Where is the middle ear? – The middle ear is behind the (tympanic membrane) and is also home to the delicate bones that aid in hearing. These bones (ossicles) are the hammer (malleus), anvil (incus) and stirrup (stapes). To provide the bigger picture, let’s look at the whole structure and function of the ear: The ear structure and function There are three main parts of the ear: outer, middle and inner.
The outer ear is the outside external ear flap and the ear canal (external auditory canal). The middle ear is the air-filled space between the eardrum (tympanic membrane) and the inner ear. The middle ear houses the delicate bones that transmit sound vibrations from the eardrum to the inner ear. This is where ear infections occur. The inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.
Other nearby parts
The eustachian tube regulates air pressure within the middle ear, connecting it to the upper part of the throat. Adenoids are small pads of tissue above the throat and behind the nose and near the eustachian tubes. Adenoids help fight infection caused by bacteria that enters through the mouth.
Middle ear infection is the most common childhood illness (other than a cold). Ear infections occur most often in children who are between age 3 months and 3 years, and are common until age 8. Some 25% of all children will have repeated ear infections. Adults can get ear infections too, but they don’t happen nearly as often as they do in children. Risk factors for ear infections include:
Age : Infants and young children (between 6 months of age and 2 years) are at greater risk for ear infections. Family history : The tendency to get ear infections can run in the family. Colds : Having colds often increases the chances of getting an ear infection. Allergies : Allergies cause inflammation (swelling) of the nasal passages and upper respiratory tract, which can enlarge the adenoids. Enlarged adenoids can block the eustachian tube, preventing ear fluids from draining. This leads to fluid buildup in the middle ear, causing pressure, pain and possible infection. Chronic illnesses : People with chronic (long-term) illnesses are more likely to develop ear infections, especially patients with immune deficiency and chronic respiratory disease, such as and, Ethnicity : Native Americans and Hispanic children have more ear infections than other ethnic groups.
Ear infections are caused by bacteria and viruses. Many times, an ear infection begins after a cold or other respiratory infection. The bacteria or virus travel into the middle ear through the eustachian tube (there’s one in each ear). This tube connects the middle ear to the back of the throat.
The bacteria or virus can also cause the eustachian tube to swell. This swelling can cause the tube to become blocked, which keeps normally produced fluids to build up in the middle ear instead of being able to be drained away. Adding to the problem is that the eustachian tube is shorter and has less of a slope in children than in adults.
This physical difference makes these tubes easier to become clogged and more difficult to drain. The trapped fluid can become infected by a virus or bacteria, causing pain. Medical terminology and related conditions Because your healthcare provider may use these terms, it’s important to have a basic understanding of them:
Acute otitis media (middle ear infection): This is the ear infection just described above. A sudden ear infection, usually occurring with or shortly after cold or other respiratory infection. The bacteria or virus infect and trap fluid behind the eardrum, causing pain, swelling/bulging of the eardrum and results in the commonly used term “ear infection.” Ear infections can occur suddenly and go away in a few days (acute otitis media) or come back often and for long periods of time (chronic middle ear infections). Otitis media with effusion: This is a condition that can follow acute otitis media. The symptoms of acute otitis media disappear. There is no active infection but the fluid remains. The trapped fluid can cause temporary and mild hearing loss and also makes an ear infection more likely to occur. Another cause of this condition is a block in the eustachian tube not related to the ear infection. Chronic suppurative otitis media: This is a condition in which the ear infection won’t go away even with treatment. Over time, this can cause a hole to form in the eardrum.
Symptoms of ear infection include:
Ear pain: This symptom is obvious in older children and adults. In infants too young to speak, look for signs of pain like rubbing or tugging ears, crying more than usual, trouble sleeping, acting fussy/irritable. Loss of appetite: This may be most noticeable in young children, especially during bottle feedings. Pressure in the middle ear changes as the child swallows, causing more pain and less desire to eat. Irritability: Any kind of continuing pain may cause irritability. Poor sleep : Pain may be worse when the child is lying down because the pressure in the ear may worsen. Fever: Ear infections can cause temperatures from 100° F (38 C) up to 104° F. Some 50% of children will have a fever with their ear infection. Drainage from the ear: Yellow, brown, or white fluid that is not earwax may seep from the ear. This may mean that the (broken). Trouble hearing: Bones of the middle ear connect to the nerves that send electrical signals (as sound) to the brain. Fluid behind the eardrums slows down movement of these electrical signals through the inner ear bones.
Ear exam Your healthcare provider will look at your or your child’s ear using an instrument called an otoscope. A healthy eardrum will be pinkish gray in color and translucent (clear). If infection is present, the eardrum may be inflamed, swollen or red.
- Your healthcare provider may also check the fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air at the eardrum.
- This should cause the eardrum to move back and forth.
- The eardrum will not move as easily if there is fluid inside the ear.
- Another test, tympanometry, uses air pressure to check for fluid in the middle ear.
This test doesn’t test hearing. If needed, your healthcare provider will order a hearing test, performed by an audiologist, to determine possible if you or your child has had long lasting or frequent ear infections or fluid in the middle ears that is not draining.
Other checks Your healthcare provider will also check your throat and nasal passage and listen to your breathing with a stethoscope for signs of upper respiratory infections. Treatment of ear infections depends on age, severity of the infection, the nature of the infection (is the infection a first-time infection, ongoing infection or repeating infection) and if fluid remains in the middle ear for a long period of time.
Your healthcare provider will recommend medications to relieve you or your child’s pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.
- Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection.
- Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older.
- If your or your child’s ear infection is severe, antibiotics might be started right away.
The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your child’s age, severity of their infection, and your child’s temperature. Their recommendations are shown in the table below.
| Child’s Age | Severity of AOM / Temperature | Treatment |
|---|---|---|
| 6 months and older; in one or both ears | Moderate to severe for at least 48 hours or temp of 102.2° F or higher | Treat with antibiotic |
| 6 months through 23 months; in both ears | Mild for < 48 hours and temp < 102.2 | Treat with antibiotic |
| 6 months to 23 months; in one ear | Mild for < 48 hours and temp < 102.2° F | Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesn’t improve within 48 to 72 hours of start of symptoms |
| 24 months or older; in one or both ears | Mild for < 48 hours and temp < 102.2° F | Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesn’t improve within 48 to 72 hours of start of symptoms |
If your healthcare provider prescribes an antibiotic, take it exactly as instructed. You or your child will start feeling better a few days after starting treatment. Even if you feel better and when pain has gone away, don’t stop taking the medication until you were told to stop.
- The infection can come back if you don’t take all of the medication.
- If the antibiotic prescribed for your child is a liquid, be sure to use a measuring spoon designed for liquid medications to be sure that you give the right amount.
- A hole or tear in your eardrum caused by a severe infection or an ongoing infection (chronic suppurative otitis media) is treated with antibiotic eardrops and sometimes by using a suctioning device to remove fluids.
Your healthcare provider will give you specific instructions about what to do. Pain-relieving medications Over-the-counter acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) can help relieve earache or fever. Pain-relieving eardrops can also be prescribed.
- These medications usually start to lessen the pain within a couple hours.
- Your healthcare provider will recommend pain-relieving medications for you or your child and provide any additional instructions.
- Never give aspirin to children.
- Aspirin can cause a life-threatening condition called,
- Earaches tend to hurt more at bedtime.
Using a warm compress on the outside of the ear may also help relieve pain. (This is not recommended for infants.) Ear tubes (tympanostomy tubes) Sometimes ear infections can be ongoing (chronic), frequently recurring or the fluid in the middle ear can even remain for months after the infection has cleared (otitis media with effusion).
Most children will experience an ear infection by age 5 and some children may have frequent ear infections. Telltale signs of an ear infection in a child can include pain inside the ear, a sense of fullness in the ear, muffled hearing, fever, nausea, vomiting, diarrhea, crying, irritability and tugging at the ears (especially in very young children).
If your child has experienced frequent ear infections (three ear infections in six months or four infections in a year), had ear infections that weren’t resolved with antibiotics, or experienced hearing loss from fluid buildup behind the eardrum, you may be a candidate for ear tubes.
- Ear tubes can provide immediate relief and are sometimes recommended for small children who are developing their speech and language skills.
- You may be referred to an ear, nose and throat (ENT) specialist for this outpatient surgical procedure, which is called a,
- During the procedure, a small metal or plastic tube is inserted through a tiny incision (cut) in the eardrum.
The tube lets air into the middle ear and allows fluid to drain. The procedure is very short — approximately 10 minutes — and there’s a low complication rate with this procedure. This tube usually stays in place from six to 12 months. It often falls out on its own, but it can also be removed by your doctor.
Will ear pain go away on its own?
When to visit your pediatrician or local urgent care – Ear pain often goes away on its own within 2-3 days. However, it’s important to watch for these signs and symptoms as they could be a sign of something more serious:
Fluid (e.g., pus or blood) draining from the ear High fever (102 degrees F or higher), headache, or dizziness Swelling behind the ear, especially if that side of the face feels weak or numb Severe pain that suddenly stops (which could indicate a ruptured eardrum) Symptoms persist or worsen Hearing loss Other symptoms that are severe or concerning
If your child is younger than 6 months and symptoms do not go away within 1-2 days, or if they have a fever, call your doctor or visit your local urgent care facility, State Urgent Care offers safe, effective ear infection treatment for people of all ages, including infants and young children.
What is the fastest way to get rid of an ear infection in adults?
Should I use antibiotics for an ear infection? – Antibiotics are a medicine prescribed by your doctor. If you’re dealing with an ear infection caused by bacteria, you’ll likely need antibiotics. They are the best way of quickly getting rid of a bacterial infection and preventing it from spreading to other parts of the body.
- The catch is that antibiotics don’t work against viruses – if you use antibiotics on a viral ear infection, it can actually make the infection worse.
- Overuse of antibiotics can lead to a condition called antibiotic resistance, which means that the medicine becomes less effective at fighting off bacteria.
That’s why doctors are careful about using antibiotics wisely and may not immediately prescribe them for ear infections.
What happens if ear pain is left untreated?
Complications – Most ear infections don’t cause long-term complications. Ear infections that happen again and again can lead to serious complications:
Impaired hearing. Mild hearing loss that comes and goes is fairly common with an ear infection, but it usually gets better after the infection clears. Ear infections that happen again and again, or fluid in the middle ear, may lead to more-significant hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur. Speech or developmental delays. If hearing is temporarily or permanently impaired in infants and toddlers, they may experience delays in speech, social and developmental skills. Spread of infection. Untreated infections or infections that don’t respond well to treatment can spread to nearby tissues. Infection of the mastoid, the bony protrusion behind the ear, is called mastoiditis. This infection can result in damage to the bone and the formation of pus-filled cysts. Rarely, serious middle ear infections spread to other tissues in the skull, including the brain or the membranes surrounding the brain (meningitis). Tearing of the eardrum. Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.
How can I treat an ear infection myself?
Your kiddo is tugging on their ear again. Uh-oh. Or maybe ear pain is keeping you up at night. No matter the age, ear infections are no fun. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
- Policy While most cases of ear infections clear up on their own, there are a handful of at-home remedies that can help, like applying a hot or cold compress, using over-the-counter pain relievers or adjusting your sleep position.
- There are several home remedies for earaches,” says ENT-otolaryngologist Anh Nguyen-Huynh, MD,
“Try them for the first two or three days if symptoms are mild.” Dr. Nguyen-Huynh explains how some of these at-home remedies work, what to avoid and when to see a doctor.
Does stress cause ear pain?
Anxiety can cause ear fullness, pressure and pain – Some people with severe chronic anxiety or panic disorder may experience ear pain and pressure, especially during a panic attack or when under a lot of stress. You may experience this as ear pressure, fullness, pain or even that your ears simply “feel weird.” You may have a near-constant urge to pop your ears to relieve the pressure, but the ear popping does little to help you feel better.
What’s the difference between earache and ear infection?
What’s the difference between an earache and an ear infection? – An earache is a pain in the ears, affecting one or both ears, and isn’t always due to bacterial infections. Ear infections, on the other hand, are caused by a bacterial or viral infection. Bacterial infections usually require treatment such as antibiotics.
How do you know if an ear infection has spread to the brain?
Loyola Otolaryngologists Find Ear Infections Can Lead to Neurological Complications | News MAYWOOD, IL – While antibiotics have greatly reduced the dangers of ear infections, serious neurological complications, including hearing loss, facial paralysis, meningitis and brain abscess still occur, according to an article in the journal,
- The article was written by Loyola Medicine Michael Hutz, MD,, and Andrew Hotaling, MD.
- It describes the symptoms, diagnosis and management of the neurologic complications of acute and chronic otitis media (middle ear infection).
- Occurs when a cold, allergy or upper respiratory infection leads to the accumulation of pus and mucus behind the eardrum, causing ear ache and swelling.
In developed countries, about 90% of children have at least one episode before school age, usually between the ages of six months and four years. Today, secondary complications from otitis media occur in approximately 1 out of every 2,000 children in developed countries.
The potential seriousness of otitis media was first reported by the Greek physician Hippocrates in 460 B.C. “Acute pain of the ear with continued high fever is to be dreaded for the patient may become delirious and die,” Hippocrates wrote. The deadliest complication of otitis media is a brain abscess, an accumulation of pus in the brain due to an infection.
The most common symptoms are headache, fever, nausea, vomiting, neurologic deficits and altered consciousness. With modern neurosurgical techniques, most brain abscesses can be suctioned or drained, followed by IV antimicrobial treatment for six to eight weeks.
- During the past 50 years, mortality worldwide from brain abscesses has decreased from 40% to 10% and the rate of full recovery has increased from 33% to 70%.
- Other complications include: Bacterial meningitis: Symptoms include severe headache, high fever, neck stiffness, irritability, altered mental status and malaise.
As the infection spreads, the patient develops more severe restlessness, delirium and confusion. Treatment is high-dose IV antibiotics for 7 to 21 days. Acute mastoiditis: This is an infection that affects the mastoid bone located behind the ear. It must be treated to prevent it from progressing to more serious complications.
Treatments include IV antibiotics and placement of a drainage tube. Hearing loss: Permanent hearing loss is rare, occurring in about 2 out of every 10,000 children who have otitis media. Facial paralysis: Prior to antibiotics, this debilitating complication occurred in about 2 out of 100 cases of otitis media.
Since antibiotics, the rate has dropped to 1 in 2,000 cases. It should be treated as an emergency. About 95% of otitis media patients who develop facial paralysis recover completely. “Antibiotic therapy has greatly reduced the frequency of complications of otitis media,” Drs.
- Hutz, Moore and Hotaling wrote.
- However, it is of vital importance to remain aware of the possible development of neurologic complication.
- In order to reduce morbidity, early deployment of a multidisciplinary approach with prompt imaging and laboratory studies is imperative to guide appropriate management.” Dr.
Hutz is a resident, Dr. Moore is an assistant professor and Dr. Hotaling is a professor emeritus in Loyola Medicine’s department of otolaryngology. Their paper is titled, “Neurological Complications of Acute and Chronic Otitis Media.” Loyola Medicine is recognized for its expert, clinically integrated team for,
Can you be hospitalized for an ear infection?
Treating mastoiditis – Mastoiditis is a serious infection and should be diagnosed and treated quickly with antibiotics, You may need to go to hospital so antibiotics can be given directly into a vein through a drip (intravenously). In some cases, surgery may be needed to either:
drain the middle ear (a myringotomy)remove part of the mastoid bone (mastoidectomy)
If you’re admitted to hospital for treatment, you’ll need to stay in for a few days until an ENT specialists can be sure the infection is under control.
What happens if an earache goes untreated?
An untreated infection can spread to other nearby tissue in and around the ear, and in rare cases even into the skull, resulting in meningitis. Infections will more commonly spread to the mastoid, just behind the ear, which can damage the bone and form pus-filled cysts.
