Ear Infection - Causes, Symptoms, Diagnosis, Prevention & Treatment

Ear infection

Dr.Anil H.T profile Authored by Dr.Anil H.T on 30 Oct 2014 - 11:42.

Ear infection (also called as acute otitis media) refers to a painful condition affecting middle ear. It is characterized by the inflammation and accumulation of excess fluid as a result of infection of the middle ear. The infective agent can be bacteria or any virus. Ear infections are common in children as compared to adults.

The reason may be attributed to presence of narrow eustachian tubes in children, which can get easily blocked, causing accumulation of fluid in the ear. Eustachian tubes are the pair of tubes in the middle ear, which regulates and maintains the air pressure in the ear, which ultimately regulates the fluid drainage in the ear. Usually, such infections affecting middle ear go away on its own, but some severe cases may require proper investigation.

As discussed, ear infection is an ultimate result of a bacterial and/ or viral infection which may be emerging from various other conditions like allergy, upper respiratory tract infections and flu. The pathogenesis behind the symptoms experienced may be associated with the inflammation and congestion of the tubes in the middle ear (eustachian tubes) as a result of an infection. Infection blocks the tubes, causing abnormal accumulation of fluid in the ear.

Sometimes, ear infection may be associated with an enlargement of a tissue located at the opening of the eustachian tubes (adenoids).  Adenoids play an important role in the immune system and are quite active in children. Inflammation of the adenoids can block the eustachian tubes, causing fluid retention.

Several other conditions may attribute to ear infection or can produce similar symptoms. These may include:

  • Inflammation and fluid retention without infection (otitis media with effusion). This often results from the dysfunction or abnormal growth in the eustachian tubes.
  • Tearing of an eardrum (suppurative otitis media).

As ear infections are common in children and they can’t express the symptoms verbally, certain signs may help to identify the presence of ear infection in children. However, in general, the onset of symptoms is often rapid in young and the old.

Common signs and symptoms in children may include:

  • A hearing problem
  • Fluid coming out of the ear
  • Pain in the ear
  • Pulling sensations in the ear/s
  • Unable to sleep
  • Getting irritated
  • Higher body temperature (more than 100 F)
  • Lack of appetite.

Common symptoms in adults may include:

  • Painful ears
  • Fluid drainage from a painful ear
  • Disturbed hearing

When to see a doctor?

Ear infections may be an alarming sign of any severe condition. So see your doctor immediately in case of the following situations:

  • If you are experiencing above symptoms for more than 24 hours.
  • Severe ear pain and fluid drainage.
  • The child is unable to sleep after cold or any other respiratory infections.

The diagnosis of ear infection often begins with the description of the symptoms experienced followed by the physical exam and certain other tests to confirm the diagnosis.

Assessment of medical history and symptoms,by enquiry of health history.

Official exam: Otoscope may be used to look into the ear for inflammation, blockage and fluid is retention.

Tympanometry: To measure the eardrum movement by adjusting the air pressure against it.

Assessing the sound reflected from the eardrum: It is called acoustic Reflectometry. Usually, eardrum absorbs most of the sound unless there is excess pressure in the middle ear and the reflected sound can be used to detect the pressure or fluid in the middle ear.

Tympanocentesis:  A procedure to take out the fluid from the eardrum and testing it further to identify the causative agent. 

Being hailed from any of the following categories may increase one’s risk of getting ear infections:

  • Children between 6 months to 24 months.
  • Exposure to contagious infections like flu and cold.
  • Feeding children by bottle (in lying down position).
  • Winters, when cold, flu and allergies are prevalent and are common
  • Exposure to air pollution.
  • Exposure to tobacco.


Although most of the ear infections get resolved without leaving any complication or other health risks, some untreated or poorly managed ear infections can lead to long-term or permanent complications which may severely affect the quality of life.  Some of the severe complications may include:

  • Significant hearing loss due to permanent damage to the internal ear parts.
  • Hearing loss can ultimately lead to delays in speech and the development of other skills.
  • Wide-spread infections to the nearby parts of the middle ear (rarely it can also affect the brain).
  • Rupture of the eardrums.

Most of the ear infections get resolved on their own in about 14 days or with certain antibiotics within few days. Following are the approaches to managing the ear infections effectively:

Drugs and medications: Doctor may prescribe certain pain killer medications to lessen the pain like ibuprofen and aspirin (recommended in children above 2 years old).

Antibiotics –antibiotics are the prominent aspect of treating many infections. Doctor may prescribe the antibiotics in following cases:

  • In children (≥ 6 months) with persistent ear pain for 2 days or with temperature ≥ 102.2 F
  • In children (6 to 23 months and above 2 years old) with mild ear pain foe less than 2 days and fever less than 102.2 F

Moreover, antibiotics may be given as drops in case of chronic supportive otitis media.

Ear drops: The doctor may prescribe eardrops to lessen the pain in those with non-perforated eardrums. Commonly prescribe eardrops may include antipyrine-benzocaine-glycerine.

Procedure to drain excess fluid (myringotomy)– It is recommended in case of recurrent otitis media or otitis media with effusion. This is done with the help of tiny tubes which are placed in the tiny hole in the eardrum (temporarily or for 6 months) which drains the fluid out and prevents further accumulation.

Warm therapy – using warm compression with the help of warm water bottle or heating pad helps to lessen the pain quickly and also prevents the further infection. Do not keep the warm compression on ear for a long time, rather keep it for a few minutes and remove it for a while and repeat the same.

Alternative therapies: These may include

Homoeopathy- It uses natural preparations of herbs and minerals to treat the symptoms. Following are some recommended natural remedies:

  • Garlic (it has anti-bacterial effects).
  • Essential oils – It helps to reduce the inflammation and helps to expel excess fluid accumulated in the ear.
  • Cod liver oil (fermented) –fulfils the requirement of vitamin A which plays an important role in the hearing physiology.
  • Colloidal Silver – It is recommended to use a warm preparation as a drop to treat the condition.
  • Onion therapy – It involves heating the onion (half portion) till the fumes come out and then placing it in the ear/s. Fumes of the onion are believed to treat the condition by removing the blockage in the tubes.

Other home remedies:

  • Heat the salt and wrap it in a thick cloth. Then put this cloth on the affected ear for about 10 minutes and repeat the procedure.
  • Prepare oil (2 garlic cloves+2 tbs sesame oil) and use itfor painful ears.
  • Apply Basil leaves (tulsi) juice gently around the affected ear.
  • Soak the cotton ball in a solution of apple cider vinegar and water/ alcohol (1:1) and plug it in the affected ear for about 5 minutes.

Healthy diet to treat the condition:

  • Avoid eating dairy products, eggs, wheat, dried fruit, sugar, corn products etc.
  • Consume vitamin C supplements and foods rich in vitamin C like oranges, pineapple and lemons.
  • Include Xylitol containing foods in your diet like fruits and natural sweetener.
  • Consume probiotic supplements.
  • Avoid exposure to atmosphere, condition or people with cold and flu or any respiratory infection.
  • Avoid exposure to polluted air.
  • Take recommended vaccinations on time (especially pneumococcal vaccines).
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.