Symptoms and Signs of Middle Ear Infection

Medical Author:
Medically Reviewed on 10/6/2021

Doctor's Notes on Middle Ear Infection

Ear infection can involve the external canal, the eardrum, and/or the middle ear (also termed otitis media). The middle ear is the space behind the eardrum containing the ossicles (ear bones) and the opening to the Eustachian tube. Infection of the middle ear has signs and symptoms of pain, dizziness, and partial hearing loss. Other symptoms may include a fullness feeling in the ear, ringing in the ear, nausea, vomiting, and vertigo. Some individuals may develop discharge from the ear.

The causes of middle ear infections are mainly bacteria or viruses that get into the middle ear, often from the Eustachian tube or from the ear canal through a break in the eardrum (tympanic membrane).

What Are the Treatments for Middle Ear Infections?

Treatments for middle ear infections depends on several factors such as the child's age, temperature (temp) and the severity of symptoms. For example:

  • Observe: no treatment
    • Children 6-23 months; mild pain in one ear <48 hours and temp <102.2 F
    • Children >24 months; mild pain in one or both ears <48 hours and a temp <102.2
  • Pain control (Do not use aspirin for patients <18 years old.)
  • Antibiotics (may be recommended by your doctor without the observation time): Treatment may depend on age. For patients >6 months with mild ear pain in one or both ears <48 hours, and a temp <102.2 F or a child 6 months and older with moderate to severe pain in one or both ears and a temp >102.2 F
  • Ear tubes: for patients with repeated long-term infections and prevention of fluid buildup
  • Antibiotic drops, fluid suction for difficult infections like suppurative otitis media

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.