Otitis media is the most common diagnosis in ill children in America. This condition primarily affects children from infants to preschoolers. Nearly all kids have at least one encounter with an ear infection before the age of six. There is a tube in the ear called the Eustachian tube. This tube is shorter in children than in adults; it allows easy entry of bacteria and viruses, leading to a middle ear infection. When this occurs, it results in acute otitis media.


The symptoms of ear infection usually appear quickly. The signs and symptoms for children consist of the following:

  • Ear pain, especially when lying down
  • Tugging or pulling at an ear
  • Trouble sleeping
  • No reaction to sounds
  • Fever of 100 F or higher
  • Drainage of fluid from the ear
  • Loss of appetite


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Risk Factors

There are several risk factors for otitis media including:

  • Age: 6 -36 months old
  • Pacifier usage
  • Group daycare
  • Bottle feed (versus breastfed) infants
  • Drinking while laying down (in infants)
  • Exposure to cigarette smoke
  • Exposure to high levels of air pollution
  • Altitude changes
  • Climate changes
  • Cold climate
  • Recent cold, flu, sinus, or ear infection
  • Genetics


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When to See the Doctor

Signs and symptoms of an ear infection could point to many different illnesses. Getting a correct diagnosis and immediate treatment is essential. You should contact a pediatrician if you notice any of the following:

  • Symptoms occur for more than one day
  • Signs exist in an infant less than six months old
  • Excruciating ear pain
  • A child is sleepless or irritable after a cold or upper respiratory infection
  • Fluid discharge, pus or bloody discharge from the ear


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Adults with Otitis Media

This ear infection could occur after any issue that keeps fluid from draining from the middle ear. Sometimes allergies, a cold, a sore throat, or a respiratory disease can be the cause. Middle ear infections are common in children, but they can also happen in adults. An ear infection may be a more severe issue for an adult than in a child. Adults may need extra testing done. You should see your health care provider for treatment if you have an ear infection. If they happen repeatedly, you should see an ear, nose, and throat specialist ear subspecialist.


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Types of Otitis Media

There are four primary types of otitis media. Acute otitis media happens abruptly. It causes swelling and redness when fluid and pus get trapped under the eardrum. This condition can cause fever and ear pain. Chronic otitis media can be chronic or recurring. A liquid may drain out of the ear canal. Tympanic membrane perforation may accompany this version of otitis media, resulting in hearing loss. Otitis media with effusion describes fluid and mucus buildup in the middle ear after the infection dissipates. People with this condition often feel as though their middle ear is full, a sensation that can continue for months and can affect hearing. Finally, chronic otitis media with effusion occurs when fluid stays in the middle ear for a long time, building up again and again, even though there is no infection.


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What Causes Otitis Media?

The middle ear is joined to the throat by a canal called the Eustachian tube. This tube assists in balancing out the compression between the outer ear and the inner ear. When you have a cold or an allergy, it can irritate the tube or cause the area around it to swell. This process can keep fluid from draining from the middle ear like it needs to. If the fluid builds up behind the eardrum, bacteria and viruses could grow in this fluid. The bacteria and viruses are what cause the middle ear infection.


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Diagnosis of a Middle Ear Infection

When you visit your doctor, they will check on your medical history and probably do a physical exam. They will look at your outer ear and inside at your eardrum with an otoscope. These are lighted tools that your doctor can use to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to inspect how good your eardrum moves. If your eardrum doesn’t move well, it could mean that you have fluid behind it. The doctor could also do an exam called tympanometry. This test tells how well your middle ear is functioning. It also indicates if there are any changes in pressure within the middle ear. The doctor may also test your hearing with an audiogram or a tuning fork.


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A middle ear infection can be treated by taking antibiotics administered orally or as ear drops, pain medications, decongestants, antihistamines, or nasal steroids. For chronic otitis media with effusion, an ear tube also called a tympanostomy tube could help. Your medical provider may also have you try auto insufflation. This process will help regulate the air pressure in your ear. During this, you pinch your nose and gently exhale. This process will force the air back through the Eustachian tube.


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Treatment Details

The particular treatment for your ear infection will be contingent on the kind you have. Generally, if your symptoms don’t get better within 48 to 72 hours, contact your doctor. Middle ear infections can create long-term difficulties if not taken care of properly. If they are addressed, these infections can lead to infections elsewhere in the head, permanent loss of hearing, and even facial nerve paralysis. In some instances, you may need a CT scan or an MRI to examine for rare causes like a cholesteatoma or tumors. If you have a middle ear infection that doesn’t improve, you should see an ear, nose, and throat specialist.


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Tubes in the Ear

Sometimes fluid from a middle ear infection remains even after you take antibiotics and the infection goes away. When this occurs, your medical provider could suggest that a small tube or a tympanostomy tube go in your ear. These tubes are placed at the opening of your eardrum. The container keeps fluid from building up and releases pressure in the middle ear. It can also help you to hear better. This procedure is also called a myringotomy. It is usually done in children but is also done for adults when needed. For adults, it is a routine process that takes less than five minutes in the office. The tubes will usually fall out on their own after around six months to a year. A specialist can place ear tubes.


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