Ear infection (middle ear) – Symptoms, Causes, Diagnosis, and Treatment

Middle Ear infection is an infection that is caused by pressure in the middle ear and it can also cause pain but it is usually preceded by an upper respiratory infection. There are mild symptoms, moderate symptoms, and severe symptoms. Mild symptoms are itching pain when you are pulling on the ear or pain when you are pushing on the ear. Severe symptoms include swelling, pain down into your neck, tender lymph nodes, high temperature of the body, and discharge. These symptoms definitely need to be treated.


A middle ear infection can be treated with antibacterial medication or it could be caused by a virus. It is really important for you to prevent further infection. One shouldn’t do swimming in areas that have high bacterial count and once the ear is wet try to get all through it out by tilting the head. It is really important for the people who are suffering from a middle ear infection to consult a health professional.

What are the types of middle ear infections?

As per medical professionals, middle ear infections are categorized into two types. These types include

  • Acute otitis media
  • Otitis media with effusion

Acute otitis media

The eardrum will be occupied with swelling and redness, and it causes ear infection and it is known as acute otitis media. As a result of this type of infection, you will experience the following symptoms. These include

  • A high temperature of the body
  • Pain in the ear
  • Hearing impairment

Otitis media with effusion

This type of ear infection can affect your hearing ability as it will build up an infection in the middle ear with the support of mucous and fluid after an infection goes away.

What are the indicators of a middle ear infection?

Pain in the ear and it is especially high when lying down, unable to hear what people are saying to you, tugging or pulling at an ear, drainage of fluid from the ear, getting difficulty in sleeping or unable to sleep, crying more than usual (In children), body running on a high temperature, fussiness, loss of balance, congestion, and trouble hearing or responding to sounds are the most common symptoms associated with this condition.

When to consult a physician

If the symptoms last more than a day or if you are unable to bear the pain then It is really important for the people who are suffering from middle ear infection should consult a health professional about what’s going on and they can review with you about your condition and help you to determine what options are best for you.

What are the causes of an ear infection?

There can be a variety of causes that can cause middle ear infection and this is very important to keep in mind. The main cause of this condition is the bacteria that grow in the eardrum. People often get diagnosed with respiratory tract infections and it can be easily spread to the ears if the person doesn’t receive the prompt treatment. As a result, it will result in pain and infection.

What are the risk factors of a middle ear infection?

There are a number of well-established risk factors developing this condition. These risk factors include

  • Age
  • Group child care
  • Infant feeding
  • Seasonal factors
  • Poor air quality
  • Alaska Native heritage
  • Cleft palate


Children who are between the ages of six months and two years have a higher risk of getting diagnosed with this infection due to their Eustachian tubes.

Group child care

Children who spend their time in a group of people are more likely to develop this condition than those who are staying home. As they live in group settings, they are often diagnosed with a common cold.

Infant feeding

Babies who drink milk, not through breastfeeding like drinking in a bottle are more likely to develop a middle ear infection.

Seasonal factors

Children, as well as adults, tend to have ear infections during the winter season.

Poor air quality

When the children are exposed to cigarette smoke or high levels of air pollution have an increased risk of getting diagnosed with a middle ear infection.

Alaska Native heritage

People who are natives to Alaska have higher chances of getting diagnosed with this condition.

Cleft palate

People may feel less pain when the eustachian tube drain but the differences in the structure of the bones of cleft palates will make this process difficult. As a result, both children and adults suffer from a lot of pain.

What are the complications of a middle ear infection?

People who experience complications due to the treatment of ear infection are very rare. The following are the complications associated with a middle ear infection. These complications include

  • Mild hearing loss to permanent hearing loss
  • Speech or developmental delays in infants and toddlers
  • Spread of infection to the nearby tissues
  • Tearing of the eardrum

When a person is experiencing the above complications due to ear infection, then it is really important for the people who are suffering from a middle ear infection to consult a health professional.

How is middle ear infection diagnosed?

In order to diagnose this condition, your physician may recommend the following tests. These tests include

  • Pneumatic otoscope
  • Tympanometry
  • Acoustic reflectometry
  • Tympanocentesis

Let’s discuss the above tests in detail.

Pneumatic otoscope

A pneumatic otoscope is an instrument used by the physician to check the fluid behind the eardrum. When there are no movements of the eardrum, then your physician assumes that it is filled with fluids and confirm the diagnosis of an ear infection.


Tympanometry is a device is used by the doctor to measure the eardrum movements. This test provides the necessary information to your physician by providing the pressure within the middle ear.

Acoustic reflectometry

This test is used to measure the sound is producing by the eardrum as well as how much it is reflecting from the eardrum. If there is more sound is coming back from the eardrum, it means the eardrum is filled with fluids.


A Tympanocentesis is a procedure that aims to drain fluid from the middle ear. Your physician may use a tiny tube to get the process done. This procedure is beneficial for people who are not responded to other treatments or previous treatments.

What are the treatment options available for a middle ear infection?

There are treatments for this which can include home remedies, pain medication, and non-prescription options as well as prescription medications.

Pain Medication

Your physician may recommend you to use the following pain-relieving medications to manage the symptoms of the condition. These medications include

  • Tylenol
  • Advil
  • Motrin IB

Take the drugs as recommended by the physician and when a child is suffering from pain, it is better to talk with the physician before giving it to the children or teenagers.

Antibiotic therapy

Your healthcare provider may recommend antibiotics to relieve you from the pain caused by an infection. Your physician may admit you in the hospital and will keep you in observation for one to two days to check how the drug is working on you.

These antibiotics can be given to the children who are younger than six months and suffering from acute otitis media are easily treated by the antibiotics. For these children, doctors can prescribe these antibiotics directly without keeping them in observation. It is really important for the people who are taking antibiotics shouldn’t miss a dose as it can lead to recurring infections. It has been observed in research that children who take antibiotics are relieved from the symptoms of middle ear infection.

Non-prescription eardrops

These eardrops are available in all the health stores and can be helpful in managing the pain and reduce the pressure of the ear. If the symptoms persist even after using the eardrops, then it is better to stop using it. A discussion with your health care provider may help determine which option would be best for you.

A wait and see approach

People who are suffering from the symptoms of ear infections usually relieved from it after a couple of days. Due to this reason, some people wait and look at whether there is any improvement in their condition and this technique is known as wait and see approach.

How to prevent this condition?

Making some changes in your lifestyle can prevent the middle ear infection and it is really important for you to prevent further infection if you are infected already.

Quitting smoking is the first step to prevent this condition because smokers are more likely to develop the upper respiratory tract and ear infections. Smoking also has its negative effects on one’s immune system and it can generate inflammation.

It is better for you to clean the outer ear regularly and also using earplugs to avoid getting water in the ears while swimming or taking a bath. It is not recommended to use cotton swabs or inserting sharp objects to clean out the ears, as it may lead to an infection.

Regular hand-washing, and taking extra precautions to not get diagnosed with seasonal allergies and skin conditions are really important for the people to prevent middle ear infection.


Ear infections may often lead to temporary hearing loss or permanent hearing loss when its lefts untreated. It is really important for the people who are experiencing the symptoms of the middle ear infection to get an accurate diagnosis and prompt treatment.


  1. https://www.ncbi.nlm.nih.gov/pubmed/30840478
  2. https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(19)30064-3

Leave a Comment