What is a middle ear infection?

A middle ear infection occurs behind the eardrum. It's most often caused by a virus or bacteria. Most kids have at least one middle ear infection by the time they are 3 years old, but adults can also get them.

What causes middle ear infections?

Inflammation in the middle ear most often starts after you’ve had a sore throat, cold, or other upper respiratory problem. The infection spreads to the middle ear and causes fluid buildup behind the eardrum. 

What are the symptoms of a middle ear infection?

These are the most common symptoms of middle ear infections in adults:

• Ear pain

• Feeling of fullness or pressure in the ear

• Fluid draining from the ear (if the eardrum has ruptured or burst)

• Fever

• Hearing loss

These symptoms may look like other conditions or health problems. Always talk with your healthcare provider for a diagnosis.

How is a middle ear infection diagnosed?

Your healthcare provider will review your health history and do a physical exam. They will check the outer ear and the eardrum using an otoscope. This is a lighted tool that lets the healthcare provider see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement. When there is fluid or infection in the middle ear, movement is decreased.

Your provider may also do a tympanometry. This is a test that directs air and sound to the middle ear.

If you have ear infections often, your healthcare provider may suggest having a hearing test.

How is a middle ear infection treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Taking medicines such as antibiotics and pain relievers

• Having a procedure to place small tubes in the eardrum for chronic ear infections 

What are possible complications of a middle ear infection?

Untreated ear infections can lead to:

• Infection in other parts of the head

• Lasting (permanent) hearing loss

• Speech and language problems

Can middle ear infections be prevented?

Cold and allergy medicines don't seem to prevent ear infections. And currently there is no vaccine that can prevent the disease. But check with your healthcare provider and make sure your vaccines are up-to-date. Living in a home where cigarettes are smoked can increase the chances of ear infections. So can living in a home where vaping devices, such as e-cigarettes and electronic nicotine, are used. Wash your hands frequently to prevent the spread of germs that cause illness.

Key points about middle ear infections

• Middle ear infections can affect both children and adults.

• Pain and fever can be the most common symptoms.

• Without treatment, permanent hearing loss may happen.

• Take antibiotics as prescribed and finish all of the prescription. This can help prevent antibiotic-resistant infections or incomplete treatment with the infection returning.

• Keeping your home smoke-free or free of vaping devices can decrease the chances of ear infections.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.