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Infection in the middle ear generally follows respiratory tract infection. This is not contagious from person to person. If not treated in time this may lead to perforation of the eardrum. This involves Middle-ear space, where nerves and small bones connect to the eardrum on one side and the eustachian tube on the other side. One of the most painful conditions in both children and adults.

Sex or Age most affected

Affects all ages, but more common in infants and children.

Signs & Symptons

  • Earache.
  • Irritability.
  • Feeling of fullness in the ear.
  • Diminished Hearing.
  • Fever.
  • Discharge or leakage from the ear.
  • Diarrhea, vomiting (sometimes).
  • Pulling at the ear (younger children).


  • Bacterial or viral infections, usually upper-respiratory tract infections of the nose or throat, which spread to the middle ear by way of the eustachian tube.
  • Sinus and eustachian-tube blockage caused by nasal allergies or enlarged adenoids.
  • A ruptured eardrum.

Risk Increases With

  • Recent illness, such as a respiratory infection, that has lowered resistance.
  • Crowded or unsanitary living conditions.
  • Genetic factors. Some children seem more susceptible.
  • High altitude.
  • Cold climate.


  • If your child has an ear infection followed by a hearing loss or enlarged adenoids, ask your doctor about using a nasal spray, preventive antibiotics, antihistamines or decongestants during future respiratory infections. This may prevent fluid accumulation.
  • Bottle- or breast-feed infants in a sitting position with head up–never lying down.

Public Complications

Usually curable with treatment but some may have

  • Eardrum rupture.
  • Hearing impairment–usually temporary, but sometimes permanent–leading to delay of normal language development in children.
  • Enlarged adenoids in children from repeated middle-ear infections, causing chronic middle-ear infections.
  • Mastoiditis (rare).
  • Meningitis (rare).

Diagnostic Measures

  • Observation of symptoms.
  • Medical history and ear exam with an otoscope.

Probable Outcomes

Usually curable in 1 week, followed by slow recovery for several weeks. A delay in treatment may result in death or long-term heart disease.


General Measures

Apply heat to the area around the ears to relieve pain


  • Use ear drops to relieve pain. You may use non-prescription drops or those prescribed for a previous infection. They will not cure the infection.
  • Use non-prescription decongestant or saline nasal sprays or drops to help open the eustachian tube and relieve pressure in the middle ear.
  • Remember nasal sprays/ nasal drops help and NOT ear drops
  • Till you contact your doctor use non-prescription drugs, such as paracetamol, to reduce pain and fever.
  • Your doctor may prescribe antibiotics if the infection appears to be bacterial rather than viral. Complete the course of medication. The infection may remain active for several days after symptoms disappear.

Contact your Doctor

The following occurs during treatment:

  • Fever above 102F (38.9C), despite treatment.
  • Severe headache.
  • Earache that persists more than 2 days, despite treatment.
  • Swelling around the ear.
  • Convulsions.
  • Twitching of the face muscles.
  • Dizziness.