8 Facts About Middle Ear Infections

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Megan Freedman on October 21, 2021
  • Human ear
    All About Otitis Media
    Otitis media, middle ear infection—and often simply, ear infection—are all names for inflammation of the middle ear. Most people who get ear infections are children—but adults can have them, too. Ear infections typically clear up with medical treatment, but serious complications are possible. Here are eight other key facts to know about middle ear infections.
  • Fever Might Mean Flu
    1. Acute otitis media is the most common type of ear infection.
    Colds, flu (influenza), allergies, and other conditions can cause inflammation in the middle ear and nearby structures—such as the eustachian tubes and adenoids. Separating the outer ear from the middle ear is a very thin membrane called the eardrum. Swelling from inflammation can trap fluid in the middle ear behind the eardrum. If bacteria or viruses become trapped within this fluid, they can multiply and create even more fluid and intense pressure in the middle ear, causing ear pain, hearing difficulty, and sometimes fever. This is an ear infection called acute otitis media (AOM).
  • Child with cold
    2. Ear infections are common in children.
    The vast majority of kids have an ear infection at some point: 5 out of 6 children will have at least one ear infection by age 3. The most common reason parents bring their children to the doctor is for ear infection.
  • Sick woman taking her temperature
    3. Adults don’t get ear infections nearly as often.
    This is because adults have longer and more vertical eustachian tubes than children. Eustachian tubes help drain fluid out of the ear and down the throat. Better fluid drainage makes it less likely for bacteria to become trapped and grow inside the ear. Adults also have smaller and more efficient adenoid glands at the back of the throat. Children’s adenoids more frequently block the eustachian tubes and hold harmful bacteria.
  • Pediatrician Checking Baby's Ears
    4. The signs and symptoms to watch for differ by age.
    If your child is beginning to talk or speaking clearly, you may hear “my ears hurt” with an ear infection. But it’s hard to know when a baby or very young child has an ear infection. The signs to look for include trouble sleeping, fever, pulling or tugging at the ears, more crying than usual, fussiness when lying down, fluid draining from the ear, and less responsiveness to sounds and noises.
  • sleeping-boy-in-bed
    5. The doctor may (or may not) prescribe antibiotics.
    In the past, doctors frequently used antibiotics to treat ear infections—assuming the cause was bacterial. Today, doctors are more selective about prescribing antibiotics. This is because antibiotics don’t help viral ear infections. And overuse of antibiotics can make them less effective. So a doctor may suggest waiting a day or two to see if the ear infection goes away on its own. In the meantime, warm compresses, over-the-counter pain relievers, and rest help ease the pain.
  • Mother and son in forest having fun
    6. Ear infections can have serious effects.
    Most middle ear infections clear up on their own or with treatment. But ear infections can turn serious, especially if they persist a long time without treatment. The eardrum and middle ear are an essential part of how you hear. Middle ear infections can cause long-term hearing loss—and in fact, they’re the most common cause of hearing loss in children. Infection inside the ear can spread to nearby organs, as well. If you think your child has an ear infection, the sooner you seek a doctor’s care, the better.
  • Portrait of boy sticking fingers in his ears
    7. Lingering fluid in the ear is a related problem.
    Occasionally, fluid remains in the middle ear after an ear infection goes away. Allergies, cigarette smoke, or an altitude change can also cause fluid to pool in the ear. This is called otitis media with effusion (OME). OME often doesn’t have symptoms or need treatment. Fluid that remains in the middle ear for more than six weeks—or goes away and returns— can result in hearing loss and a higher risk of infection. Surgery to drain the fluid is a treatment option for OME. A surgeon places temporary tubes, sometimes called pressure-equalizing tubes in the eardrum. Ear tube surgery is a quick, safe procedure performed with anesthesia.
  • child receiving vaccination
    8. You can help prevent ear infections.
    Ear infections often follow a cold or flu, so vaccinating yourself and your children—especially for flu, pneumonia and meningitis, is a great way to prevent ear infections. Avoid irritants like cigarette smoke because they can cause inflammation, swelling, and fluid buildup in the middle ear. Breastfeed your baby if possible—substances in breast milk help protect against ear infections. It’s also important to bottle feed your baby as they are sitting up instead of lying down. Drinking while lying down can cause block their eustachian tubes and lead to ear fluid buildup. As always, wash your and your children’s hands often to prevent germs from spreading.
8 Facts About Middle Ear Infections

About The Author

  1. Ear Infection Information. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/pages/Ear-Infection...
  2. Ear Infection. Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/community/for-patients/common-illnesses/ear-infection.html
  3. Ear Infections in Children. National Institute on Deafness and Other Communications Disorders. http://www.nidcd.nih.gov/health/hearing/otitismedia.asp
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  5. Earaches and Otitis Media. American Academy of Otolaryngology-Head and Neck Surgery. http://www.entnet.org/?q=node/1312
  6. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013;131(3):e964-e999
  7. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss. American Academy of Otolaryngology-Head and Neck Surgery. http://www.entnet.org/HealthInformation/otitisMediaHearingLoss.cfm
  8. Middle Ear Infections. KidsHealth from Nemours. http://kidshealth.org/parent/infections/ear/otitis_media.html
  9. Otitis Media with Effusion (OME). This Children’s Hospital of Phildelphia. http://www.chop.edu/conditions-diseases/otitis-media-effusion-ome#.Vd9IkrSA2JU
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Last Review Date: 2021 Oct 21
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