Ear infections: everything you need to know

The ears are an essential component of our auditory system. Like any other body organ, ears can also catch infections.

Bacterial and viral infections can cause ear infections. These infections can occur in the outer, middle (part of the ear just behind the eardrum), and inner ear.

Most ear infections subside on their own. Sometimes ear infections may cause pain due to fluid buildup and inflammation.

Types of ear infections

Based on duration, an ear infection can be:

• Acute ear infections: They are short-duration but can be painful.

• Chronic ear infections: long-term infections occur when they do not clear up or recur frequently. Chronic ear infections in extreme situations may cause permanent damage to the middle and inner ear.

How do you know if you have an ear infection?

Some of the common symptoms of an ear infection are:

• The feeling of discomfort or mild pain inside the ear

• Pressure or heaviness inside the ear

• Discharge from ears

• Some degree of hearing loss

Sometimes these symptoms persist or may fade away with time. A person can experience symptoms in either or both ears.

The intensity of symptoms can be more severe when the infection is present in both ears. Also, the severity of the symptoms is less in chronic ear infections.

Children may manifest some additional signs when contracting ear infections, such as:

• Fever

• When they are constantly rubbing or pulling their ear

• Not responding to certain sounds

• Losing balance frequently

• Headache

• Restlessness

• Anorexia or loss of appetite

Most ear infections subside within a few days, but some may persist for more than a week.

If your child (younger than six months) has ear infections, immediately go for a doctor's consultation. If your child has a fever of more than 102°F or severe pain in the ear, go for immediate medical attention.

What are the causes and risk factors for an ear infection?

Ear infections can be due to various bacteria (most commonly Streptococcus pneumonia) and viruses (most commonly Haemophilus influenza). These infections often result from the blockage of Eustachian tubes. The eustachian tubes are small tubes connecting the ears and the back of the throat. The blockage of the eustachian tube leads to fluid buildup in the middle ear.

Your Eustachian tube may get blocked because of various conditions, such as:

• Cold

• Allergy

• Sinusitis

• Excess mucus production

• Tobacco smoking

• Changes in air pressure

Another cause of ear infection can be infected adenoids. Adenoid glands are situated on the roof of the posterior mouth, posterior to the nasal cavity. Adenoids protect us from various infections. But sometimes, adenoid infections can spread to nearby Eustachian tubes.

What are the risk factors for infection in the ears?

• Age: Most ear infections occur in younger children. The main reason lies in the size and shape of eustachian tubes. Children have short and narrow tubes susceptible to fluid blockage.

• Bottle-fed infants have higher chances of ear infections than the ones who breastfed

• Changes in altitude, temperature, and humidity

• Exposure to cigarette smoke

• Recent illness

• Being a male

• Low birth-weight 

What can be the potential complications of an ear infection?

Though it is rare, sometimes ear infections may cause severe complications, such as:

• Hearing loss

• Speech, language, or other developmental delays in children

• Infection of the mastoid bone in the skull (mastoiditis)

• Infection of the membranes of the brain and spinal cord (meningitis)

• Eardrum rupture

How can I manage my ear infections?

Most ear infections go away on their own without any treatment intervention.

Some of the treatment options that can manage symptoms of ear infection are:

• Home treatment

Some of the home remedies that can be effective in relieving symptoms of mild ear infections:

• Apply a warm cloth on the affected ear

• Ear drops to relieve pain

• Decongestants

• Medical treatment

If the symptoms of ear infections worsen, consult a doctor. Your doctor may prescribe antibiotics if it is a bacterial infection. For children, the doctor may follow a wait-and-watch approach to avoid irrational antibiotic usage.

• Surgery

If the ear infections do not respond to medical treatment, your doctor may recommend ear tube surgery or myringotomy.

When should I consult an ENT specialist?

Close monitoring of the symptoms is essential for a child with an ear infection. You can immediately seek an expert consultation when your child shows the following symptoms:

• Fever more than 102.2°F

• Discharge or fluid leaking from your ear

• Worsening of existing symptoms

• Symptoms lasting more than three days

• Hearing impairment

As an adult, you should consult an ENT specialist if your symptoms last more than 2 to 3 days with pain and fever.

What are the diagnostic tests for an ear infection?

Your ENT specialist will first take a detailed history of your symptoms. He will then examine your ears by inserting an instrument with a light and magnifying glass. This instrument is called an otoscope and may reveal the following upon examination:

• redness

• air bubbles

• the pus-like fluid inside the middle ear

• discharge from the middle ear

• perforation, bulging, or collapsed eardrum

Some of the additional tests for ear infections are:

• Fluid sample: The doctor may take a fluid sample from your ear if your infection is not responding to treatment. A fluid examination can detect the type of infection-causing bacteria to help the doctor to figure out the best possible antibiotic therapy.

• Computed tomography or CT scan: Your ENT specialist may prescribe CT Head to see the extent of infection beyond the middle ear.

• Blood tests: The doctor may recommend blood tests to check your immune function.

• Tympanometry: It helps the doctor measure the response of your eardrum to air pressure changes inside the ear.

• Acoustic reflectometry: It measures the quantity of sound reflected from your eardrum. This test determines the amount of fluid in your ear.

• Hearing test

How can I prevent ear infections?

Some of the easy tips to prevent ear infections are:

• Maintain hand hygiene

• Avoid overcrowded areas

• Breastfeeding infants

• Quit smoking

• Avoid secondhand smoke

• Get all your immunizations as per the schedule

The Conclusion

Bacteria and viruses may cause infections in your middle ear (part of the ear behind your eardrum). Most of these ear infections resolve within three days. Sometimes your doctor may prescribe antibiotics to manage the symptoms. Kids less than two years are susceptible to ear infections due to anatomical factors. Consult a doctor immediately if your child has severe pain, high fever, and ear drainage.