If you’re experiencing discomfort or pressure in your inner ear, accompanied by pus drainage or hearing loss, these may be signs of an ear infection. Over-the-counter (OTC) treatments can help, but persistent symptoms warrant medical consultation.

Ear infections can be bacterial or viral in origin and may affect the middle, outer, or inner ear. While often self-resolving, they can cause pain due to inflammation or fluid buildup.

Infections may present as acute (intense but short-lived) or chronic, where symptoms persist or recur frequently. Chronic cases risk permanent damage to middle and inner ear structures.

Continue reading to learn about causes, symptoms, and treatment options for ear infections.

Table of Contents

1. Ear infection symptoms
2. Causes and risk factors
3. Potential complications
4. Treatment options
5. When to seek medical care
6. Diagnosis methods
7. Prevention strategies

Ear infection symptoms

Common indicators include:

• Ear discomfort or pain
• Persistent ear pressure
• Pus discharge
• Hearing difficulties

Symptoms may fluctuate and affect one or both ears. Bilateral infections typically cause more severe pain.

Chronic cases often present with milder symptoms than acute episodes.

In children, additional signs may include:

• Ear tugging
• Fever
• Reduced sound responsiveness
• Balance issues
• Headaches
• Irritability
• Appetite loss

Most infections resolve within three days, though symptoms may persist up to a week.

Infants under six months with fever or infection symptoms require medical evaluation. Seek immediate care for children with fever exceeding 102°F (39°C) or severe ear pain.

Causes and risk factors

Common pathogens include Streptococcus pneumoniae and Haemophilus influenzae. Infections often develop when Eustachian tubes become blocked, causing middle ear fluid accumulation. These tubes connect the ears to the throat and regulate pressure.

Blockage contributors include:

• Allergies
• Colds
• Sinus infections
• Excess mucus
• Smoking
• Air pressure changes

Infected adenoids may also spread infection to Eustachian tube openings.

Children are particularly susceptible due to their shorter, narrower Eustachian tubes. About 80% experience acute ear infections.

Bottle-fed infants show higher incidence than breastfed counterparts.

Additional risk factors:

• Altitude changes
• Climate variations
• Secondhand smoke
• Pacifier use
• Recent illness
• Male gender
• Low birth weight
• Limited healthcare access
• Daycare attendance

Potential complications

While most infections resolve without issue, potential complications include:

1. Hearing impairment: Persistent fluid may cause temporary or permanent hearing loss, particularly concerning for children’s speech development.
2. Eardrum rupture: Severe pressure may perforate the eardrum, often healing spontaneously but sometimes requiring intervention.
3. Chronic suppurative otitis media: Characterized by persistent pus drainage, potentially causing ongoing hearing issues.
4. Mastoiditis: Rare infection spreading to mastoid bone behind the ear, requiring prompt treatment.
5. Facial nerve issues: Severe infections may inflame facial nerves, causing weakness.
6. Labyrinthitis: Inner ear infection causing vertigo and balance problems.
7. Brain-related complications: Extremely rare cases may involve meningitis or abscesses requiring emergency care.

Monitor symptoms closely and seek prompt treatment if complications are suspected. Early intervention prevents long-term consequences.

Treatment options

Mild cases often resolve with self-care:

Home care:

• Warm compress application
• OTC pain relievers (ibuprofen, acetaminophen)
• Pain-relieving ear drops
• Decongestants (pseudoephedrine)
• Avoiding pressure on affected ear

Medical treatment:

Persistent or severe cases may require antibiotics for bacterial infections. Note antibiotics don’t treat viral infections.

Pediatric considerations:

Doctors often delay antibiotics for children to prevent resistance. Complete any prescribed antibiotic course (typically 7-10 days of amoxicillin). Never give children aspirin due to Reyes’ syndrome risk.

Surgical options:

For recurrent or persistent cases:

• Ear tube placement to drain fluid
• Myringotomy (eardrum incision)
• Adenoid removal if enlarged

When to seek medical care

The CDC recommends medical evaluation for children with:

• Fever >102.2°F
• Ear discharge
• Worsening symptoms
• Symptoms lasting >2-3 days
• Hearing loss
• Concerning symptoms

Adults should consult a doctor for symptoms persisting beyond 2-3 days or with severe pain/fever.

Diagnosis methods

Healthcare providers use otoscopes to examine ears, checking for:

• Redness or pus
• Fluid drainage
• Eardrum perforation
• Eardrum abnormalities

Additional tests may include:

• Fluid culture for resistant bacteria
• CT scans for infection spread
• Blood tests for immune function
• Tympanometry for eardrum response
• Acoustic reflectometry for fluid
• Hearing tests for chronic cases

Prevention strategies

Reduce infection risk by:

• Frequent handwashing
• Avoiding crowded spaces during cold season
• Limiting pacifier use
• Breastfeeding when possible
• Avoiding secondhand smoke
• Maintaining current vaccinations

Ear infections typically stem from middle ear bacterial or viral presence. While most resolve in about 3 days, severe cases may require antibiotics.

Children are most susceptible. Seek medical attention for severe pain, high fever (>102.2°F), ear drainage, or concerning symptoms in yourself or your child.