Ear infection (middle ear)


A middle ear infection, also known as acute otitis media, is an inflammation of the air-filled area behind the eardrum where the tiny vibrating bones of the ear are located. Ear infections are more common in children than in adults.

The eustachian tubes, which are small tubes that connect the middle ear to a high point in the back of the throat, may swell and get clogged as a result of an ear infection. This may cause middle ear mucous to accumulate. This mucus may become infected and result in symptoms of an ear infection.

Since ear infections frequently go away on their own, pain management and problem-monitoring may be the first steps in treatment. Antibiotics may occasionally be used to treat infections. Multiple ear infections can be a frequent problem for some people. This may lead to major issues including hearing loss.


The signs and symptoms of an ear infection typically appear quickly.

Symptoms in children

Common child signs and symptoms include:

  • Ear pain, particularly while lying down
  • Pulling or tugging on the ear
  • Sleeping problem
  • A fever of at least 100 F (38 C).
  • Fluid discharge from the ear
  • Cry more often than normal
  • Irritability
  • Difficulty hearing or reacting to sounds
  • Loss of balance
  • Headache
  • Diminished appetite

Symptoms in adults

Typical adult warning signs and symptoms include:

  • Pain in the ear
  • Fluid discharge from the ear
  • Hearing problem

A number of illnesses might be indicated by the signs and symptoms of an ear infection. It’s crucial to have quick treatment and a precise diagnosis. Contact your child’s physician if

  • The symptoms persist for more than a day.
  • Symptoms manifest in an infant under 6 months of age.
  • Severe ear pain
  • Following a cold or another upper respiratory infection, your infant or toddler is restless or cranky.
  • You notice a fluid, pus, or bloody fluid coming from the ear.


A bacterium or virus in the middle ear causes an ear infection. This infection frequently develops as a result of another sickness, such as a cold, the flu, or an allergy, which enlarges and congests the nasal passages, throat, and eustachian tubes.

Middle ear

The hammer, or malleus; the anvil, or incus; and the stirrup, or stapes, are the three tiny bones that make up the middle ear. The bones are kept out of the outer ear by the eardrum. The middle ear connects to the upper portion of the throat and the back of the nose by a tiny passageway known as the eustachian tube. Your inner ear includes a snail-shaped structure called the cochlea.

Function of eustachian tubes

A pair of small tubes called the eustachian tubes extend from each middle ear to a high spot in the back of the throat, behind the nasal passages. The throat end of the tubes open and shut in order to:

  • Control the middle ear’s air pressure
  • Refresh air in the ear
  • Drain the middle ear of its secretions.

Eustachian tubes that are swollen and then plug themselves might result in fluid accumulation in the middle ear. The symptoms of an ear infection may develop if this fluid is infected.
The eustachian tubes are more horizontal and narrower in youngsters, which makes it harder for them to drain and increases the likelihood that they will become clogged.

Function of adenoids

Two tiny tissue pads called adenoids are located high on the back of the nose and are thought to influence immune system function.
Adenoids are located close to the eustachian tubes’ opening, so swelling could prevent the tubes from opening. A middle ear infection may result from this. Due to the fact that children’s adenoids are larger than adults’, adenoid’s swelling and irritation are more likely to contribute to childhood ear infections.

Related issues

The following middle ear conditions might cause comparable middle ear issues or be connected to ear infections:

  • Otitis media with effusion, without a bacterial or viral infection, the middle ear swells and fluid accumulates (effusion). This could take place because the fluid buildup continues even after the ear infection has subsided. It could also be brought on by eustachian tube dysfunction or a non-infectious obstruction.
  • Chronic otitis media with effusion, happens when fluid in the middle ear persists and keeps coming back without bacterial or viral infection. Children become more prone to ear infections and their hearing may suffer as a result.
  • Chronic suppurative otitis media, an ear infection that does not clear up after being treated as normal. This may result in an eardrum hole.

Risk factors

The following are risk factors for ear infections:

  • Age. Because of the size and structure of their eustachian tubes and because their immune systems are still maturing, children between the ages of 6 months and 2 years are more prone to ear infections.
  • Race. Native Alaskans are more likely to have ear infections.
  • Family history: It’s possible for ear infections to run in families.
  • Colds: Ear infections are more likely to occur if you have a cold.
  • Chronic diseases: Your risk of ear infections can be increased by long-term illnesses like immunological deficiencies and chronic respiratory conditions (such cystic fibrosis and asthma).
  • Cleft palate. The eustachian tube may drain more slowly in children with cleft palates due to differences in their bone structure and muscles.
  • Infant feeding. Compared to breastfed newborns, babies who drink from a bottle, especially when lying down, are more likely to get ear infections.
  • Seasonal factors. The fall and winter months are when ear infections are most prevalent. When pollen counts are high, those with seasonal allergies may be more susceptible to ear infections.
  • Taking care of children in groups. Compared to children who stay at home, children in group settings are more likely to get colds and ear infections. Children who are in groups are more likely to contract illnesses like the common cold.
  • Air pollution. Ear infections can become more likely if you are exposed to tobacco smoking or a lot of air pollution.