All you need to know about ear infection

Overview

An ear infection (sometimes called acute otitis media) is an infection of the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to having multiple ear infections. This can cause hearing problems and other serious complications.

Symptoms

The onset of signs and symptoms of ear infection is usually rapid.

Children

Signs and symptoms common in children include:

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• Ear pain, especially when lying down
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• Tugging or pulling at an ear
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• Trouble sleeping
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• Crying more than usual
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• Fussiness
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• Trouble hearing or responding to sounds
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• Loss of balance
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• Fever of 100 F (38 C) or higher
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• Drainage of fluid from the ear
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• Headache
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• Loss of appetite
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Adults

Common signs and symptoms in adults include:

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• Ear pain
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• Drainage of fluid from the ear
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• Trouble hearing
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CAUSES

An ear infection is caused by a bacterium or virus in the middle ear. This infection often results from another illness — cold, flu or allergy — that causes congestion and swelling of the nasal passages, throat and eustachian tubes.

Role of eustachian tubes

The eustachian tubes are a pair of narrow tubes that run from each middle ear to high in the back of the throat, behind the nasal passages. The throat end of the tubes open and close to:

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• Regulate air pressure in the middle ear
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• Refresh air in the ear
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• Drain normal secretions from the middle ear
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Swollen eustachian tubes can become blocked, causing fluids to build up in the middle ear. This fluid can become infected and cause the symptoms of an ear infection.

In children, the eustachian tubes are narrower and more horizontal, which makes them more difficult to drain and more likely to get clogged.

Role of adenoids

Adenoids are two small pads of tissues high in the back of the nose believed to play a role in immune system activity.

Because adenoids are near the opening of the eustachian tubes, swelling of the adenoids may block the tubes. This can lead to middle ear infection. Swelling and irritation of adenoids is more likely to play a role in ear infections in children because children have relatively larger adenoids compared to adults

Risk factors

Risk factors for ear infections include:

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• Age: Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their eustachian tubes and because their immune systems are still developing.
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• Group child care: Children cared for in group settings are more likely to get colds and ear infections than are children who stay home. The children in group settings are exposed to more infections, such as the common cold.
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• Infant feeding: Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast-fed.
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• Seasonal factors: Ear infections are most common during the fall and winter. People with seasonal allergies may have a greater risk of ear infections when pollen counts are high.
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• Poor air quality: Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infections.
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