Ear Infections

Ear infections occur when bacteria or viruses get inside the ear, causing swelling and pain. They can affect people of all ages but are more common in children.

Many times, an ear infection will go away on its own. But if it lingers, doctors may prescribe medicine or surgery to treat it.

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On this page

• What Are Ear Infections?
• What Are the Symptoms of an Ear Infection?
• How Do You Diagnose Ear Infections?
• How Do You Treat an Ear Infection?

What Are Ear Infections?

Doctors define ear infections as an inflammation of the ear.

Ear infections are common in kids. In fact, 5 out of 6 children will have an ear infection by their 3rd birthday.

Adults can get them too, but not as often.

Ear infections often clear up on their own. If they don't, antibiotics are the standard ear infection treatment.

What are the types of ear infections?

The ear has three distinct parts:

• Outer ear, everything we see on the outside plus the ear canal. The ear canal begins at the ear's opening and extends to the eardrum.
• Middle ear, the area between the eardrum and inner ear. Three tiny bones in the middle ear relay sound vibrations to the inner ear. This is where most ear infections occur.
• Inner ear, contains the cochlea, an organ shaped like a snail. It converts sound vibrations into electrical signals that travel to the brain.

There are different types of ear infections. The most common is a middle ear infection.

Middle ear infections include:

• Acute otis media (AOM). This is the most common type of middle ear infection. It happens when parts of the middle ear become infected. The area becomes swollen, and fluid gets trapped behind the eardrum.
• Otis media with effusion (OME). This may happen after an acute ear infection runs its course, but fluid stays trapped behind the eardrum. A child with OME may not have any symptoms.
• Chronic otis media with effusion (COME). This happens when fluid remains in the middle ear or returns many times, even without infection. This fluid can affect your child's hearing and makes it harder for them to fight infections.

Infections can also happen in the:

• Outer ear (swimmer's ear). This happens when water stays in the ear canal and provides a moist, warm place for bacteria to grow.
• Inner ear (labyrinthitis). This inflammation of the inner ear is more common in adults than kids. Inner ear infections can affect your hearing and balance, causing vertigo and tinnitus.

What causes ear infections?

Bacteria and viruses cause ear infections. In a middle ear infection, fluid builds up in the Eustachian tubes behind the eardrum.

Children are more likely than adults to get middle ear infections because their Eustachian tubes are small. The tubes are also more level and likely to get clogged.

Ear infections tend to begin after you or your child has:

• A cold.
• A sore throat.
• Allergies.
• An upper respiratory infection.

Are ear infections contagious?

No. Ear infections aren't contagious.

But the bacterial or viral infections that cause them — colds, sore throats, respiratory infections — may be contagious.

What are the risk factors and complications of ear infections?

Ear infection risk factors

Some factors that make you or your child more prone to ear infections include:

• Attending group day care.
• Being between 6 months and 2 years old.
• Being exposed to secondhand smoke.
• Drinking from a bottle lying down.
• The change of seasons. More ear infections happen in the fall and winter months.

Complications of ear infections

Most ear infections are mild and clear up quickly.

But chronic ear infections may lead to:

• A tear in the eardrum.
• Delays in speech or development.
• Impaired hearing.

How can I prevent ear infections?

You can't prevent all ear infections.

But you can reduce the risk of ear infections if you:

• Avoid people who have colds or other upper respiratory illnesses.
• Don't let your baby have a bottle lying down.
• Don't smoke and avoid secondhand smoke.
• Dry your child's ears after swimming.
• Get the recommended vaccines for the whole family, including flu and pneumonia vaccines.
• Breastfeed. It protects against AOM during the first two years of life.
• Manage your allergies.
• Wash your hands after using the bathroom, eating, and being around large groups of people.

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What Are the Signs and Symptoms of Ear Infections?

Ear infection symptoms are usually easy to spot.

They include:

• Crying.
• Ear pain.
• Fever (especially in babies and toddlers).
• Fluid draining from the ear or ears.
• Fussiness.
• Having a hard time sleeping.
• Problems with balance.
• Trouble hearing.
• Tugging or pulling at the ear or ears.

How Do You Diagnose Ear Infections?

The doctor will:

• Ask you whether you or your child has been sick lately.
• Look in the affected ear with a special lighted instrument.

If the eardrum looks red and is bulging, it's likely an ear infection.

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How Do You Treat Ear Infections?

If you or your child shows signs of ear infection, you should call your doctor.

UPMC offers the latest in ear infection treatment.

Once your doctor makes an ear infection diagnosis, they'll give you or you child a treatment plan.

Watchful waiting

Most ear infections clear up on their own in a few days. Your doctor may suggest waiting 2 or 3 days for the immune system to fight off the infection. Overuse of antibiotics can lead to

Medicines to treat ear infections

• Antibiotics. Your doctor may prescribe an antibiotic for a bacterial ear infection. Antibiotics don't work against viral infections. And overuse can lead to antibiotic resistance.
• Over-the-counter (OTC) pain relievers. Your doctor may suggest acetaminophen or ibuprofen, depending on your child's age. You should never give children aspirin because it can cause Reye's syndrome, a serious disease of the liver and brain.
• Steroids. If you or your child has an inner ear infection, your doctor may prescribe steroids to reduce swelling.

Tubes to treat ear infections

If your child has recurring ear infections, your doctor may advise tubes.

They'll insert small drainage tubes in the eardrum to help remove trapped fluid.

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Last reviewed by Donna L. Geraci, CRNP on 2024-04-24.