Ear Infection

About

Ear infections are one of the most common reasons parents take their children to the doctor. The most common type of ear infection is called otitis media. It is caused by swelling and infection of the middle ear. The middle ear is located just behind the eardrum.

An acute ear infection starts over a short period and is painful. Ear infections that last a long time or come and go are called chronic ear infections.

Causes

The eustachian tube runs from the middle of each ear to the back of the throat. Normally, this tube drains fluid that is made in the middle ear. If this tube gets blocked, fluid can build up. This can lead to infection.

• Ear infections are common in infants and children because the eustachian tubes are easily clogged.
• Ear infections can also occur in adults, although they are less common than in children.

Anything that causes the eustachian tubes to become swollen or blocked makes more fluid build up in the middle ear behind the eardrum. Some causes are:

• Allergies
• Colds and sinus infections
• Excess mucus and saliva produced during teething
• Infected or overgrown adenoids (lymph tissue in the upper part of the throat)
• Tobacco smoke

Ear infections are also more likely in children who spend a lot of time drinking from a sippy cup or bottle while lying on their back. Getting water in the ears will not cause an acute ear infection, unless the eardrum has a hole in it.

Acute ear infections most often occur in the winter. You cannot catch an ear infection from someone else. But a cold that spreads among children may cause some of them to get ear infections.

Risk factors for acute ear infections include:

• Attending day care (especially centers with more than 6 children)
• Changes in altitude or climate
• Cold climate
• Exposure to smoke
• Family history of ear infections
• Not being breastfed
• Pacifier use
• Recent ear infection
• Recent illness of any type (because illness lowers the body's resistance to infection)

Symptoms

In infants, often the main sign of an ear infection is acting irritable or crying that cannot be soothed. Many infants and children with an acute ear infection have a fever or trouble sleeping. Tugging on the ear is not always a sign that the child has an ear infection.

Symptoms of an acute ear infection in older children or adults include:

• Ear pain or earache
• Fullness in the ear
• Feeling of general illness
• Vomiting
• Diarrhea
• Hearing loss in the affected ear

The ear infection may start shortly after a cold. Sudden drainage of yellow or green fluid from the ear may mean the eardrum has ruptured.

All acute ear infections involve fluid behind the eardrum. At home, you can use an electronic ear monitor to check for this fluid. You can buy this device at a drugstore. You still need to see a health care provider to confirm an ear infection.

When to Contact a Medical Professional

Call your child's provider if:

• Pain, fever, or irritability do not improve within 24 to 48 hours
• At the start, the child seems sicker than you would expect from an ear infection
• Your child has a high fever or severe pain
• Severe pain suddenly stops this may indicate a ruptured eardrum
• Symptoms get worse
• New symptoms appear, especially severe headache, dizziness, swelling around the ear, or twitching of the face muscles

Let the provider know right away if a child younger than 6 months has a fever, even if the child doesn't have other symptoms.

Prevention

You can reduce your child's risk of ear infections with the following measures:

• Wash hands and toys often.
• If possible, choose a day care that has 6 or fewer children. This can reduce your child's chances of getting a cold or other infection, and lead to fewer ear infections.
• DO NOT use pacifiers.
• Breastfeed -- This makes a child much less prone to ear infections. If you are bottle feeding, hold your infant in an upright, seated position.
• DO NOT expose your child to secondhand smoke.
• Make sure your child's immunizations are up to date. The pneumococcal vaccine prevents infections from the bacteria that most commonly cause acute ear infections and many respiratory infections.
• DO NOT overuse antibiotics. Doing so can lead to antibiotic resistance.

Alternative Names

Otitis media - acute; Infection - inner ear; Middle ear infection – acute