Middle Ear Infection (Otitis Media)

What is a middle ear infection?

A middle ear infection is an infection of the air-filled space in the ear behind the eardrum. Anyone can get an ear infection, but ear infections are more common in children less than 8 years old.

How does it occur?

Ear infections usually begin 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 the delicate parts of the middle ear from the air and moisture 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 health care provider will ask about your symptoms and look at your eardrum.

Your health care provider may check for fluid in the ear. This test is performed with a small device in the ear canal. A puff of air is blown into the ear and movement of the eardrum is measured. 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 health care 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 (Tylenol) or ibuprofen. Carefully follow the directions for using medicines, even if they are nonprescription.

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 health care 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 and loosely plug the ear with cotton to catch further drainage. If you have a lot of fluid and pus draining from your ear, the eardrum has probably ruptured and there may be a more serious infection. Ask your health care provider how to care for ear discharge in your case.
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. Anyone under the age of 21 with a viral illness should not take aspirin because of the increased risk of Reye's syndrome.
- Keep a daily record of your temperature.
Call your health care provider if you have:
- a temperature over 102 degrees F (38.9 degrees C) that persists 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 your hearing
- weakness of one side of your face.
Keep all your appointments. Your health care 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 health care 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.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File ENT3950F.HTM Release 9.0/2006