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Ear infections

Overview of ear infections

Either a virus or a bacterium could cause ear infections. This infection could affect any part of the ear; based on affected part of the ear, it is divided into three types:

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  • Otitis externa (infections of the external ear, which is of the auditory canal, up to the eardrum)
  • Otitis media (infections of the middle ear, which lies just behind the eardrum)
  • Otitis interna (infections of the inner ear)

Otitis media is the most common ear infection and it is prevalent among children and adults. It could either acute (lasting a few days) or chronic (lasting a few weeks to even a few years). If not managed properly, chronic otitis media can have long-term implications, leading to complications, which could even lead to the extent of affecting the brain.

An ear infection usually occurs when a person is affected with sore throats, colds and other respiratory and breathing problems. This results in accumulation of fluid in the middle ear. Children are the worst victims of ear infections since their immune system is not developed enough to fight the infections. If the ear infection is not treated, the accumulated fluid can lead to increased pressure behind the eardrum, leading to its rupture.1

Signs and Symptoms of ear infections

Ear infections are difficult to detect in children, because they are not able to express. Parents have to take cues from their behavior and any associated symptoms of cold or throat infections, and signs they show are helpful in diagnosing the ear infections.

The signs and symptoms of ear infections include the following:

  • Mild or severe earache due to which, one may face trouble during sleep
  • Fever
  • Thick, yellow fluid coming out from their ears
  • Plugged sensation in the ear or fullness in the ear
  • Trouble in hearing
  • Vomiting
  • Diarrhea
  • Symptoms of cold
  • Tugging or pulling of one or both ears
  • Loss of balance

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Causes ear infections

Ear infections are caused when the bacteria make their way to the middle ear through the Eustachian tube and produce infection. This causes swelling of the middle ear and blockage of the Eustachian tube. The white blood cells are unable to fight infection and often die due to the blockage, leading to the formation of pus (thick yellowish-white fluid). Ear infections are commonly seen in winter season and can spread among children.2 Children are more prone for ear infections, as their Eustachian tube is small and can get easily blocked.

The following are some of the causes, which lead to the blockage of the Eustachian tube or the upper airways.

Diagnosis ear infections

Diagnosis of ear infections is based on the signs and symptoms or allergies. A thorough examination of throat, sinuses, head, neck and lungs is conducted. The physician uses an otoscope to visualize the ears and see the following:3

  • Air bubbles.
  • Fluid behind the eardrum.
  • Perforations in the eardrum.

Tympanometry may be useful, as it provides information about the condition of the middle ear. Based on the examination and test findings, the physician may suggest a hearing test, especially if the infections are frequently affecting the person. Hearing tests are also useful in determining the extent of hearing loss. A specialist called audiologist conducts hearing tests.

Treatment ear infections

The goal of treating ear infections would be the following:4

  • Curing the infection
  • To prevent complications
  • To relieve pain
  • To prevent recurrent infections

Antibiotics are helpful in clearing the infections and prevent the recurrent infections.5 Surgery (myringotomy) may be suggested to relieve the pressure and allow the drainage of fluid. Surgical removal of the enlarged adenoids may be suggested if the infections are recurrent.

Prevention ear infections

The following are some of the prevention strategies:6

  • Avoiding the children to play with sick playmates.
  • Avoiding exposure to pollution or tobacco smoke.
  • Quit smoking.
  • Infants should be breast-fed.


1.Berman S. Otitis media, shared decision making, and enhancing value in pediatric practice. Arch Pediatr Adolesc Med. 2008; 162: 186–188.

2.Paradise JL, Feldman HM, Campbell TF Dollaghan CA, Rockette HE, Pitcairn DL. et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. New Eng J Med. 2007: 356(3): 248–261.

3.Rowe LD. Otitis media with effusion section of otolaryngology-Head and neck surgery. In: Doherty GM, Way LW (eds). Current Surgical Diagnosis and Treatment, 12th edn, 2006, pp. 943–944.

4.amakrishnan K, Sparks RA, Berryhill WE. Diagnosis and treatment of otitis media. Am Fam Physician. 2007; 76(11): 1650–1658.

5.lasziou PP, Hayem M, Del Mar CB. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev. 2000: 2.

6.American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004; 113(5): 1451–1465.


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