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Middle Ear Infection In Infants, Toddlers, Children, and Adults

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Middle ear infection definition and facts

  • Middle ear infections or inflammation (otitis media) are inflammation, usually caused by infection, of ear tissue including the ear drum and tissues behind it, but not the ear canal.
  • It is the most common childhood condition for which antibiotics are prescribed.
  • Signs and symptoms include:
    • Fever
    • Ear pain
    • A feeling of fullness in the ear
  • Young children will have these symptoms and signs as well as fussiness and feeding problems.
  • The infection or inflammation causes fluid buildup in the middle ear.
  • A cold or other respiratory infection can lead to ear infections or inflammation.
  • Those at a higher risk for middle ear infections are children exposed to other children's colds (as often occurs in daycare centers), and babies who are bottlefed.
  • Middle ear pus causes pain and temporary hearing loss.
  • Rupture of the eardrum allows the pus and fluid to drain into the ear canal.
  • Ear infections are treated with observation, antibiotics, or ear tubes.
  • Routine childhood and yearly flu vaccinations may help prevent this type of infections

What is middle ear infection or inflammation?

Middle ear inflammation is also called otitis media. Otitis media is inflammation of the middle ear; however, many doctors consider otitis media to be either inflammation or infection of the middle ear, the area inside the ear drum (tympanic membrane - see illustration). "Otitis" means inflammation of the ear, and "media" means middle. This inflammation often begins with infections that cause sore throats, colds or other respiratory problems, and spreads to the middle ear. Infections can be caused by viruses or bacteria, and can be acute or chronic. Both ears can be infected at the same time (double ear infection). These infections are not "swimmers ear" (also termed otitis externa or outer ear infection because it occurs in the ear canal up to the ear drum), but not beyond. However, some people can have swimmer's ear and a middle ear infection at the same time.

Acute middle ear infections usually are of rapid onset and short duration. They typically are associated with fluid accumulation in the middle ear together with signs or symptoms of infections in the ear in addition to a bulging eardrum usually accompanied by pain or a perforated eardrum, often with drainage of purulent material (pus, also termed suppurative otitis media). The person also may have a fever.

Chronic middle ear infections are a persistent inflammation of the middle ear, typically for a minimum of three months. This is in distinction to an acute ear infection that usually lasts only several weeks. Following an acute infection, fluid (an effusion) may remain behind the ear drum (tympanic membrane) for up to three months before resolving. It may develop after a prolonged period of time with fluid (effusion) or negative pressure behind the eardrum (tympanic membrane). This type of infection can cause ongoing damage to the middle ear and eardrum, and there may be continuing drainage through a hole in the eardrum. Chronic middle ear infections often starts painlessly without fever. Ear pressure or popping can be persistent for months. Sometimes a subtle loss of hearing can be due to chronic middle ear infections.

Picture of the Ear Anatomy
Picture of the Ear Anatomy
Medically Reviewed by a Doctor on 3/16/2017


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