Middle Ear Infection: Symptoms and When to Treat

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 12/07/2020

Ear pain is right up there on the miserable-scale with toothaches. It can feel unbearable. And while ear infections may be more common in children, that doesn’t mean they deliver child-size discomfort.

Your first response to an earache may just be to pop some Tylenol and hope for the best. But understanding why you’re feeling this pain, and what can happen when you ignore it, may motivate you to call a healthcare provider. 

What Is a Middle Ear Infection (Otitis Media)? 

A middle ear infection, also known as acute otitis media, is an infection that happens behind the eardrum. This portion of the ear canal is known as the middle ear, and also includes the eustachian tubes (tubes that run from your ear to the back of your throat). 

The eustachian tubes act as plumbing for your ears, draining fluids into your throat so they can be carried out of your body, eventually. But, when the eustachian tubes get blocked, that fluid builds up, which can lead to infection.

Otitis media can be caused by viral or bacterial infections. Viral infections include those that cause the common cold, whereas bacterial infections include things such as streptococcus pneumoniae (also known as pneumococcus) haemophilus influenzae, and Moraxella catarrhalis.

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Otitis Media Symptoms 

Symptoms of a middle ear infection are unpleasant — quite obviously. Most commonly, people with ear infections experience pain and difficulty hearing, as the inflammation of an ear infection hinders the ability of the tiny bones in your middle ears (ossicles) to transfer vibrations to your inner ear and ultimately your brain. 

Other middle ear infection symptoms may include: 

  • Fever

  • Loss of appetite 

  • Fluid draining from the ear 

  • Nausea 

  • Feeling of fullness in the ears

  • Hearing loss

When your eustachian tubes block fluid from draining, the pressure of this build-up can ultimately cause your eardrum to rupture. Signs of this ear infection complication may include dizziness and nausea, as well as buzzing or ringing in the ears.

Left untreated, a serious ear infection can lead to lasting hearing loss, speech problems, and infection that spreads to other parts of the body.

Risk Factors for Middle Ear Infections 

Middle ear infections are more common in children because they have shorter, more horizontal and narrower eustachian tubes that make it easier for bacteria to find its way into the middle ear, and easier for blockages to form. 

Also, glands at the back of the throat, known as adenoids, are larger in children and can get in the way of drainage into the throat. But adults get ear infections too! 

Allergies and colds may increase your risk of developing an ear infection. Also, cigarette or tobacco smoke (whether your own or second-hand) can increase your risks.

Cold weather, altitude changes, family history, recent illnesses, or structural defects of the ear are additional risk factors for middle ear infections.

Though ear infections are not contagious, the viruses that may cause them can be. In other words, you won’t catch an ear infection from someone else, but you could catch a cold which leads to an ear infection.

Treating a Middle Ear Infection

Taking over-the-counter pain relievers like acetaminophen and ibuprofen can help manage the discomfort and reduce inflammation as you wait for the infection to subside.

Your healthcare provider may want to look in your ear using an instrument called an otoscope. 

They’ll be looking for redness and inflammation. They may deliver a puff of air into the ear to see how the eardrum responds — a stiff eardrum or one with fluid behind it will not budge. 

If you have reoccurring ear infections or an ear infections with significant hearing loss, they  may also check for hearing problems using an audiogram. 

Call your healthcare provider right away if you have a high fever, discharge or pus coming from your ear. 

Also call your healthcare provider immediately if you experience severe pain, if that severe pain suddenly stops (as this may signify a ruptured ear drum), symptoms that seem to get worse or don’t improve after a few days, if new symptoms develop (like swelling around your ear, dizziness, twitching of the facial muscles or a severe headache) or if you experience hearing loss.

In severe cases, where the infection doesn’t respond to treatment, a healthcare provider may suggest putting in ear tubes. This procedure is done by an ear, nose and throat specialist   (also referred to as an ENT or otolaryngologist). They may also recommend removing the tonsils or adenoids if you experience recurrent infections.

If you’re at all concerned that your ear infection is more serious than it seems or if the pain is unbearable, erring on the side of precaution and calling a medical professional will put your mind at ease and potentially prevent serious complications.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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