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Eye & EarICD-10: H66About 80% of children will have at least one ear infection by age 3

Ear Infection

Also known as: Otitis Media, Middle Ear Infection, Acute Otitis Media

An ear infection (otitis media) is an infection of the middle ear, the air-filled space behind the eardrum containing the tiny vibrating bones of hearing. It is most common in children but can occur at any age, often following a cold or upper respiratory infection. Most ear infections resolve on their own or with antibiotics, but recurrent infections may require surgical intervention.

Symptoms

Ear pain, especially when lying down
Tugging or pulling at the ear (in young children)
Difficulty sleeping
Fever, especially in children
Fluid drainage from the ear
Difficulty hearing or responding to sounds
Loss of balance
Irritability and crying (in infants)

Causes

  • Bacterial infection (Streptococcus pneumoniae, Haemophilus influenzae)
  • Viral infection of the upper respiratory tract causing eustachian tube swelling
  • Eustachian tube dysfunction trapping fluid behind the eardrum
  • Allergies causing eustachian tube inflammation

Risk Factors

  • Age 6 months to 2 years
  • Group childcare or daycare attendance
  • Bottle-feeding while lying down
  • Seasonal factors (fall and winter)
  • Exposure to tobacco smoke or air pollution
  • Family history of ear infections

Diagnosis

  • Otoscopic examination of the eardrum
  • Pneumatic otoscopy to assess eardrum mobility
  • Tympanometry to measure middle ear pressure and fluid
  • Hearing test if hearing loss is suspected

Treatment

  • Watchful waiting for mild cases in children over 2 years
  • Antibiotics (amoxicillin first-line) for bacterial infections
  • Pain management with acetaminophen or ibuprofen
  • Warm compresses for comfort
  • Ear tube surgery (myringotomy) for recurrent infections

Prevention

  • Keep up-to-date on vaccinations, especially pneumococcal and flu vaccines
  • Practice good hand hygiene
  • Breastfeed infants for at least 6 months if possible
  • Avoid exposing children to secondhand smoke

When to See a Doctor

  • Symptoms last more than 2–3 days without improvement
  • Fever is higher than 102.2°F (39°C)
  • Fluid, pus, or bloody discharge drains from the ear
  • Your child is under 6 months old with symptoms of an ear infection

Frequently Asked Questions

Related Conditions

Influenza

Infectious

Laryngitis

Respiratory

Sinusitis

Respiratory

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.