Understanding Ear Infections: Symptoms, Treatment and Prevention

Ear infections are a painful nuisance, but if left untreated, they can have serious repercussions. Although children are most susceptible, they aren't just a childhood malady — adults can also get them.

Here are some important facts about ear infections, including what to do if you get one and steps you can take to prevent them.

What Is an Ear Infection?

An ear infection occurs when either a virus or bacteria cause inflammation and fluid buildup in the middle ear.¹

Types of ear infections

There are three main types of middle ear infections:²

1. Acute otitis media is a sudden onset of swelling and redness caused by a virus or bacteria, often accompanied by ear pain and fever.
2. Otitis media with effusion is a continuation of fluid buildup that lingers in the middle ear after the infection is gone. It can cause pressure in the middle ear and may affect hearing.
3. Chronic otitis media with effusion is a middle ear infection similar to otitis media with effusion, but it either remains for a long time after the infection is gone or occurs repeatedly without the return of an actual infection.

Additionally, two other types of ear infections commonly affect the inner and outer ear:

1. Otitis externa, more commonly known as “swimmer's ear," is an infection in the outer ear canal caused by bacterial growth in water that gets trapped inside the ear.³
2. Labyrinthitis is an inner ear infection that can cause dizziness, vertigo, nausea and hearing loss.⁴

Ear infections are more common in children than in adults, although they can happen at any age.¹ Child ear infection symptoms may differ from those in adults.

Ear infection symptoms in children¹

• Fussing or crying
• Ear tugging
• Ear fluid drainage
• Fever
• Sleeplessness
• Difficulty hearing
• Difficulty with balance

Ear infection symptoms in adults²

• Ear pain
• Throat pain
• Dampened hearing
• Ear fluid drainage

Fever and difficulty with balance may also occur, but are less likely in adults.²

What Causes Ear Infections?

Ear infections are generally caused by either bacteria or viruses, such as the common cold virus.⁵ The two most common bacteria responsible for ear infections are:

• Streptococcus pneumoniae. This bacteria is responsible for illnesses like pneumonia and meningitis, but can also cause ear and sinus infections.⁶
• Haemophilus influenzae. Unrelated to the viruses that cause influenza, this bacteria can cause several different types of infections, including ear infections and blood infections.⁷

Ear infections typically happen when an infectious cold or allergy causes irritation and swelling around the eustachian tube, a canal running between the throat and the middle ear that evens out pressure between the inner and outer ear. Swelling around this tube blocks drainage and causes fluid to build up behind the eardrum, creating an environment for bacteria and viruses to incubate and grow.²

Certain conditions place people at higher risk of developing an ear infection. These include:²

• Developing a cold or upper respiratory infection
• Smoking or being around second-hand smoke
• Respiratory allergies, either seasonal or year-round

Are Ear Infections Contagious?

Ear infections are not themselves contagious. But they can result from a contagious illness like the common cold or flu, which are passed through droplets from the mouth or nose.⁸ Contracting one of these illnesses can increase your likelihood of developing an ear infection, but it doesn't guarantee you'll get one.

Ear Infections vs. Earaches

Although an earache usually accompanies an ear infection, earaches can have many different causes. A sore throat, toothaches and jaw pain can all cause ear pain, and so can an ear injury or irritation of the nerves inside the ear. Changes in altitude can cause the ears to “pop," sometimes resulting in an earache.

By itself, ear pain doesn't necessarily mean you have an ear infection. But if the pain persists or is accompanied by other symptoms, it's a good idea to see your doctor to rule out an infection.⁹

Diagnosing Ear Infections

Ear infections are typically diagnosed by assessing your medical history and conducting a physical examination of the ear. Using a lighted tool called an otoscope, your healthcare practitioner will peer inside the ear to see if it looks inflamed. They may also use a pneumatic otoscope, which blows a puff of air to test the movement of the eardrum. This can tell whether there's fluid buildup behind the eardrum.²

If a physical examination doesn't provide clear evidence for a diagnosis, your doctor may run a tympanometry test to measure the flexibility of the eardrum. A tympanometer is a device that can be inserted into the ear and deliver tones of sound and varied amounts of ear pressure to measure how the eardrum reacts.¹

Read Related: 7 Different Types of Hearing Tests and How They Work

Ear Infection Treatment Options

Standard ear infection treatment typically consists of a combination of antibiotics and over-the-counter (OTC) pain medications, as well as decongestants to relieve pressure from fluid buildup and treat any fever that may be present.² If the infection is caught early, your doctor may hold off on prescribing antibiotics for a few days to see if the infection clears up on its own.⁵

For chronic or chronically recurring ear infections, surgery may be done to place a small tube in the eardrum to prevent fluid buildup. These tubes fall out after six to nine months. If infections continue even after ear tube placement, then your doctor may recommend surgically removing the adenoids so they'll no longer be able to spread infection to the eustachian tubes.¹

What Can Happen if Ear Infections Aren't Treated?

Left untreated, ear infections can have lasting effects on your or your child's health. These may include:²

• Hearing loss
• Nerve damage causing partial facial paralysis
• Spread of infection throughout the head

If an ear infection doesn't get better with treatment, you should see an ear, nose and throat specialist (an ENT) for further testing. They may conduct an MRI or CT scan to see if there's something more serious than a simple infection behind the symptoms.²

How Much Does It Cost To Treat an Ear Infection?

Here's a typical cost breakdown involved in treating an ear infection.

How To Prevent Ear Infections

• Get vaccinated against the flu and pneumonia, both of which are common causes of ear infections.¹
• Practice hand washing and good hygiene.¹
• Limit your child's exposure to sick children as much as possible.¹
• Avoid smoking or being around second-hand smoke.¹
• Be sure to dry your ears completely after bathing or swimming.³

Coping With an Ear Infection

When dealing with an ear infection, it's important to get plenty of rest while your body goes to work fighting it off.⁵ Here are a few more things you can do to help yourself or a loved one feel better:

• Drink plenty of fluids.⁵
• Place a warm compress against the ear, or use a heating pad on the low setting.
• A cold compress or ice pack might also help with pain.
• Avoid sleeping on the affected ear, which can worsen pain.
• Use a hair dryer on the low or cool setting to dry out excess fluid in the ear.

Seeking Treatment for Ear Infections

Ear infections can be a painful nuisance. Although they can sometimes go away on their own, especially if you have a healthy immune system, ear infections that don't improve on their own within a couple of days can have lasting repercussions, including hearing damage. It's important to pay attention to the symptoms of an ear infection and seek professional treatment if symptoms persist.

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Author Bio

Jean Marie Bauhaus is a freelance writer and novelist with eight years of experience. Her work has appeared on Hill's Pet, Chewy and AKC.org, and more.