Ear Infections – Symptoms and Causes

Overview

An ear infection happens when the middle ear becomes infected. The middle ear is the space behind your eardrum, and it contains small bones for hearing.

Children get these infections more often than adults do. The infection usually develops when tubes called eustachian tubes become swollen and blocked. These tubes connect your middle ear to the back of your throat.

When these tubes are blocked, fluid builds up in the middle ear. This fluid can become infected with bacteria or viruses, causing pain and other symptoms.

Many ear infections clear up without treatment, so doctors often suggest pain management and watching the infection before prescribing medicine.

If needed, antibiotics help fight bacterial infections. Some people get ear infections repeatedly, which can lead to hearing loss and other problems if not treated properly.

Treatment Options

• Pain relievers (over-the-counter medications)
• Antibiotics (for bacterial infections)
• Ear drops (to reduce pain and inflammation)
• Warm compresses (for comfort)

Signs of Ear Infection

In Children

Children with ear infections often show these symptoms:

• Pain in the ear, particularly when lying down
• Pulling at the ear
• Difficulty sleeping
• More crying than usual
• Irritability
• Reduced hearing or response to sounds
• Balance problems
• Temperature of 100°F (38°C) or higher
• Fluid coming from the ear
• Head pain
• Reduced interest in food

In Adults

Adults experiencing ear infections typically have:

• Pain in the ear
• Fluid draining from the ear
• Hearing difficulties

These symptoms usually develop quickly in both children and adults. If you notice these signs, seeking medical advice is important for proper treatment.

When to See a Doctor

Contact your child’s doctor if ear infection symptoms continue for more than one day. For babies under 6 months old, call a doctor as soon as symptoms appear. Other important warning signs include:

• Severe ear pain
• Irritability or sleep problems after a cold
• Fluid, pus, or blood coming from the ear

These symptoms might indicate a serious infection that needs proper medical attention. Early treatment can prevent complications and help your child feel better faster.

Why Ear Infections Happen

Inside the Middle Ear

The middle ear contains three tiny bones called the hammer (malleus), anvil (incus), and stirrup (stapes). These bones sit behind the eardrum, which keeps them separated from the outer ear.

A small passage called the eustachian tube connects the middle ear to the throat and back of the nose. This connection is important for proper ear function. The inner ear contains the cochlea, which looks like a snail’s shell and helps with hearing.

How Eustachian Tubes Work

Eustachian tubes are narrow channels that run from each middle ear to the back of the throat. These tubes have several important jobs:

• Balancing air pressure in the middle ear
• Bringing fresh air into the ear
• Draining normal fluids from the middle ear

When these tubes become swollen or blocked, fluid builds up in the middle ear. This trapped fluid can become infected by bacteria or viruses, causing an ear infection.

Children have a harder time with ear infections because their eustachian tubes are:

• Narrower (easier to block)
• More horizontal (harder to drain properly)

How Adenoids Affect Ear Health

Adenoids are small patches of tissue located high in the back of the nose. They help fight infections as part of the immune system. Because adenoids sit near the openings of the eustachian tubes, problems happen when they become swollen.

Swollen adenoids can block the eustachian tubes, leading to fluid buildup and ear infections. This problem affects children more often because their adenoids are larger compared to the size of their ears and throat.

Adults typically have smaller adenoids, which is why they get fewer ear infections.

Conditions Connected to Ear Infections

Several middle ear conditions are related to ear infections:

• Otitis media with effusion – This happens when fluid builds up in the middle ear without an active infection. The fluid might stay after an ear infection clears up or appear because of blocked eustachian tubes.
• Chronic otitis media with effusion – This condition occurs when fluid repeatedly returns to the middle ear without infection. Children with this problem:
  • Get ear infections more easily
  • May have hearing problems
• Chronic suppurative otitis media – This is a stubborn ear infection that doesn’t respond to standard treatments. If left untreated, it can damage the eardrum, sometimes creating a hole.

Risk Factors

Several factors can increase the chance of getting ear infections:

• Age: Young children (6 months to 2 years old) face higher risks because their ear tubes are smaller and their immune systems are still developing.

• Group childcare settings: Children in daycare centers or schools catch more colds, which can lead to more ear infections due to increased exposure to germs.

• Feeding methods: Bottle-fed babies, especially those fed while lying down, tend to have more ear infections than breastfed infants.

• Seasonal changes: Fall and winter months bring more ear infections. People with seasonal allergies may experience more problems when pollen counts rise.

• Air quality issues: Exposure to cigarette smoke or high pollution levels can harm the respiratory system and increase infection risk.

• Alaska Native heritage: Children with Alaska Native background have higher rates of ear infections.

• Cleft palate: The different bone and muscle structure in the palate can affect how ear tubes drain, making infections more likely.

Complications

Ear infections typically resolve without lasting problems. However, frequent ear infections can cause several serious issues. Hearing problems may occur during and after ear infections.

While mild, temporary hearing loss is common, it usually improves as the infection clears. Recurring infections or middle ear fluid can lead to more significant hearing loss.

In some cases, damage to the eardrum or middle ear structures may cause permanent hearing loss.

Children with hearing impairment from ear infections may face developmental challenges. Infants and toddlers might experience delays in speech, social skills, and overall development if hearing is affected.

Untreated infections can spread beyond the ear. Mastoiditis occurs when the infection spreads to the mastoid bone behind the ear, potentially causing bone damage and pus-filled cysts.

In rare cases, serious infections can spread to brain tissues or the protective membranes around the brain. Eardrum tears sometimes happen during ear infections. Most heal naturally within 72 hours, but some tears require surgical repair.

Prevention

Reducing the risk of ear infections involves several key steps. These steps can help both children and adults stay healthier.

Good hygiene practices are essential. Teach children to wash hands thoroughly and not share eating utensils. Show them how to cough or sneeze into their elbow rather than their hands.

When possible, limit exposure to large group child care settings where germs spread easily. Keep your home and surroundings smoke-free. Secondhand smoke increases the risk of ear infections, so ensure no one smokes in your home.

For babies, breastfeeding provides important protection. If possible, breastfeed for at least six months as breast milk contains antibodies that help fight infections.

When bottle-feeding, always hold your baby in an upright position. Never prop bottles or place them in the crib, as this can increase infection risk.

Vaccinations play a crucial role in prevention. Discuss with your doctor which vaccines are appropriate. These include seasonal flu shots, pneumococcal vaccines, and other bacterial vaccines.

These immunizations help strengthen the immune system against infections that can lead to ear problems.