Ear Infection (Otitis Media): Causes, Symptoms, Types, Treatment and Prevention

Introduction

Have you ever had ear pain that made it difficult to sleep, or noticed that sounds suddenly seem muffled? For parents, it can be especially worrying when a child wakes up at night crying and holding their ear, complaining of discomfort. Otitis media is an infection or inflammation of the middle ear. Fluid or mucus can build up behind the eardrum, which may cause ear pain, pressure, or muffled hearing¹.

This blog explains what otitis media means, the main types of middle ear infection, common causes, symptoms, prevention tips, when to seek medical care, and how ear infections are usually treated.

What Is an Ear Infection (Otitis Media)?

An ear infection, also called otitis media when it affects the middle ear, often develops after a cold, sore throat, or other respiratory infection². Fluid can collect behind the eardrum and make it harder for sound to pass through clearly¹. Ear infections are more common in children, although adults can also develop them. A child with an ear infection may pull at the ear, cry more than usual, sleep poorly, have balance problems, or seem less responsive to sounds¹.

Types of Ear Infection

There are three main types of middle ear infection. They differ mainly in how quickly symptoms start and how long fluid or infection remains behind the eardrum².

• Acute otitis media: This type develops suddenly and causes inflammation, swelling, and redness in the middle ear. Fluid and mucus may become trapped behind the eardrum, leading to symptoms such as ear pain and fever.
• Otitis media with effusion: After an ear infection improves, fluid and mucus may remain or continue to collect in the middle ear. This can cause a feeling of fullness in the ear and may lead to hearing difficulties, although some people may have no noticeable symptoms.
• Chronic suppurative otitis media: It refers to persistent infection in the middle ear leading to a hole (perforation) in the eardrum and persistent or recurring ear discharge.
• Chronic otitis media with effusion: In this type, fluid stays in the middle ear for a prolonged period or repeatedly returns. It can affect hearing and may make the ear more vulnerable to further complications.

Causes of Ear Infection

A middle ear infection can be caused by bacteria or viruses. It often follows a cold or another upper respiratory infection, which can make the Eustachian tube swollen or blocked. This tube normally helps drain fluid from the middle ear and balance pressure³.

• Bacterial infection: Bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis can cause acute otitis media.
• Viral infection: Viruses, including respiratory syncytial virus, influenza virus, parainfluenza virus, rhinovirus, and adenovirus, can cause acute otitis media.
• Upper respiratory infection: A viral upper respiratory infection commonly occurs before an ear infection and can contribute to its development by disrupting Eustachian tube function.
• Eustachian tube dysfunction: Problems with the Eustachian tube can interfere with normal middle ear ventilation and promote inflammation and infection.

Symptoms of Ear Infection

Middle ear infection symptoms often appear quickly and may improve over a few days. Symptoms can look different in adults, older children, babies, and younger children⁴.

• Earache: Ear pain is the most common symptom in adults and older children.
• Slight hearing loss: Some people may notice reduced hearing, particularly when the middle ear is filled with fluid.
• Fluid or pus from the ear: A hole may sometimes develop in the eardrum, allowing pus to drain from the ear.
• Rubbing or tugging the ear: Younger children may rub or pull at the affected ear.
• Crying or irritability: Young children may become more irritable or cry more than usual, particularly with a fever.
• Being sick or reduced feeding: Younger children may vomit or feed less than usual.
• Low energy: A child with an ear infection may have less energy than usual.
• Cough or runny nose: These symptoms may occur when the ear infection follows a cold or other respiratory infection.
• Diarrhoea: Diarrhoea can occur in young children with otitis media infection.
• Difficulty hearing or reduced response to quiet sounds: A young child may appear inattentive or not respond to quieter sounds.
• Loss of balance: Some children may experience problems with balance.

Treatment of Ear Infection

Treatment depends on the person’s age, symptoms, general health, and risk of complications. Many middle ear infections improve on their own within a few days, so treatment may focus first on relieving pain and fever. Antibiotics are used when symptoms are severe, when the infection does not improve, or when the person is at higher risk of complications^2,5.

• Pain and fever relief: Pain relievers and fever medicines may help reduce discomfort. Use medicines only as directed by a doctor or according to the product label^2,5.
• Antibiotics: A doctor may prescribe oral antibiotics for some middle ear infections, especially if the child is very unwell, symptoms are severe, or there is a higher risk of complications. Ear drops may be used in specific situations, such as when there is ear discharge or a perforated eardrum, but they should be used only as advised by a healthcare professional^2,5.
• Ear tubes or myringotomy: In some children with repeated infections or fluid that stays in the middle ear for several months, a specialist may recommend a small opening in the eardrum and placement of tiny tubes. These tubes help fluid drain and reduce pressure².
• Adenoid removal: In selected children with repeated ear infections, a specialist may recommend removing the adenoids if they are contributing to the problem².
• Antihistamines and decongestants: These medicines are not usually recommended for speeding recovery from middle ear infections. Ask a doctor before using them, especially in children⁵.
• Observation: For mild infections, a doctor may suggest watching symptoms for 2 to 3 days while using pain relief. If symptoms worsen or do not improve, antibiotics may then be considered^2,5.

Home Remedies for Ear Infection

The following home-care steps may help ease earache or pressure while you wait for the infection to improve or while following medical advice⁶:

• Apply a cold pack: Place a cold pack or cold, wet washcloth on the outer ear for about 20 minutes to help reduce pain.
• Chew: Chewing may help relieve the pain and pressure associated with an ear infection. Gum should not be given to young children because it can be a choking hazard.
• Rest upright: Sitting or resting in an upright position instead of lying down can help reduce pressure in the middle ear.
• Use ear drops only when appropriate: Over-the-counter pain-relieving ear drops may help some people, but they should not be used if fluid is draining from the ear or if the eardrum may be perforated unless a doctor says they are safe.
• Take appropriate pain relievers: Over-the-counter pain medicines can help relieve earache in children and adults. Follow the dose instructions and ask a doctor if you are unsure what is safe.
• Swallow or chew during air travel: For ear pain caused by changes in altitude, swallowing or chewing during the airplane’s descent may help. Infants can suck on a bottle or breastfeed during descent.

Possible Complications of Ear Infection

Most ear infections get better within a few days, and complications of otitis media are uncommon. However, when complications occur, the infection can spread to nearby parts of the ear or head^4,7.

• Hearing loss: Ear infections can cause hearing loss, which is usually temporary⁴.
• Perforated eardrum: A hole can develop in the eardrum, sometimes causing fluid or pus to drain from the ear⁴.
• Mastoiditis: The infection can spread to the bone behind the ear, known as the mastoid⁴.
• Labyrinthitis: The infection can spread to the inner ear, referred to as labyrinthitis⁴.
• Meningitis: In rare cases, the infection can spread to the protective membranes around the brain and spinal cord, known as meninges⁴.
• Facial nerve problems: An ear infection can sometimes lead to problems involving the facial nerve⁴.
• Chronic infection or cholesteatoma: Ear infections can sometimes lead to a persistent infection or cholesteatoma, which is an abnormal build-up of skin cells in the ear⁴.
• Long-term hearing or speech effects: Untreated or repeated ear infections can, in some cases, lead to lasting hearing problems or affect speech and language development in children².

Prevention Tips for Ear Infections

These steps may help lower the risk of middle ear infections:

For Adults

• Keep vaccinations up to date: Recommended vaccines, such as flu and pneumococcal vaccines, can help lower the risk of some infections that may lead to middle ear infections⁷.
• Avoid exposure to cigarette smoke: Avoiding smoking and staying away from second-hand smoke exposure can help reduce the risk of developing ear infections^4,7.
• Take care while swimming and showering: Use earplugs or a swimming cap while swimming if advised, dry the ears well afterwards, and try to keep shampoo and water out of the ears while bathing^8,9.
• Avoid putting cotton buds or fingers in the ear: Do not insert fingers, cotton buds, or other objects into the ear canal⁹.

For Babies and Children

• Keep vaccinations up to date: Recommended vaccines, such as flu and pneumococcal vaccines, can help lower the risk of some infections that may lead to middle ear infections⁷.
• Do not wean off your baby too quickly: Breastfeeding may help reduce the risk of infections overall^4,7.
• Limit dummy or pacifier use: Limiting or avoiding dummy or pacifier use, especially after 12 months of age, may help reduce risk^4,7.
• Keep small objects away from babies: Supervise your baby so they do not put small items in their ears, as this can cause injury or infection⁷.
• Avoid feeding while lying flat: Try not to feed your baby while they are lying on their back⁷.

When Should You Consult a Doctor?

Seek medical advice if you or your child has symptoms of an ear infection:

• Symptoms are getting worse or last more than 2 to 3 days⁸.
• Fever is 39°C (102.2°F) or higher, or continues for more than 5 days¹⁰.
• A baby under 3 months has a temperature of 38°C (100.4°F) or higher⁸.
• Pus, discharge, or fluid is draining from the ear^8,10.
• There is new or worsening hearing loss⁸.
• There is swelling, redness, or increasing pain behind the ear, or the individual develops dizziness or loss of balance^4,10.
• You have a medical condition that could increase the risk of complications, including congenital heart disease or cystic fibrosis^4,7.
• Your immune system is compromised, for example because of chemotherapy.
• The individual develops a severe headache, neck stiffness, breathing problems, dehydration, a seizure, unusual drowsiness, or a rash that does not disappear when pressed¹⁰.

Conclusion

Middle ear infections, or otitis media, are common, particularly in children, and often improve on their own. Recognising symptoms such as ear pain, fever, hearing difficulties, or ear discharge can help you know when medical advice may be needed. Simple preventive measures and appropriate home care can help reduce discomfort and the risk of infection, while timely medical attention can help prevent complications.

Also Read: Natural Home Remedies for Ear Pain

Frequently Asked Questions (FAQs)

References

1. Ear Infections. Accessed August 13, 2026. https://medlineplus.gov/earinfections.html
2. Ear Infection (Otitis Media). October 29, 2024. Accessed August 13, 2026. https://www.hopkinsmedicine.org/health/conditions-and-diseases/otitis-media
3. Matz O, Sutton AE, Ashurst JV. Acute Otitis Media. In: StatPearls. StatPearls Publishing; 2026. Accessed August 13, 2026. http://www.ncbi.nlm.nih.gov/books/NBK470332/
4. Middle ear infection (otitis media) | nidirect. October 19, 2017. Accessed August 13, 2026. https://www.nidirect.gov.uk/conditions/middle-ear-infection-otitis-media
5. Australia H. Otitis media (middle ear infection). June 19, 2025. Accessed August 13, 2026. https://www.healthdirect.gov.au/otitis-media
6. Earache: MedlinePlus Medical Encyclopedia. Accessed August 13, 2026. https://medlineplus.gov/ency/article/003046.htm
7. Middle ear infection (otitis media). NHS inform. Accessed August 13, 2026. https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/middle-ear-infection-otitis-media/
8. CDC. Ear Infection Basics. Ear Infection. March 23, 2026. Accessed August 13, 2026. https://www.cdc.gov/ear-infection/about/index.html
9. Ear infections. nhs.uk. January 25, 2018. Accessed August 17, 2026. https://www.nhs.uk/conditions/ear-infections/
10. NHS_STW_Otitis_Media_Advice_Sheet.pdf. Accessed August 13, 2026. https://stw-healthiertogether.nhs.uk/application/files/5916/7404/6879/NHS_STW_Otitis_Media_Advice_Sheet.pdf
11. Ear infections. nhs.uk. January 25, 2018. Accessed August 13, 2026. https://www.nhs.uk/conditions/ear-infections/

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