Middle Ear Infection

With this condition, the middle ear becomes infected and inflamed. The middle ear is located behind the eardrum.

  • Causes

    Bacteria and viruses (most common) cause this condition. Common bacteria include:

    • Streptococcus pneumoniae
      (most common)
    • Haemophilus influenzae
    • Moraxella (Branhamella) catarrhalis
    • Streptococcus pyogenes
      (less common)

  • Definition

    With this condition, the middle ear becomes infected and inflamed. The middle ear is located behind the eardrum.

    The Middle Ear
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  • Diagnosis

    The doctor will ask about symptoms and medical history, and perform a physical exam. Most middle ear infections can be diagnosed by looking into the ear with a lighted instrument, called an otoscope.

    The doctor will see if there is fluid or pus behind the eardrum. A small tube and bulb may be attached to the otoscope. This is to blow a light puff of air into the ear. The puff helps the doctor see if the eardrum is moving normally.

    Other tests may include:

    • Tympanometry—measures pressure in the middle ear and responsiveness of the eardrum,
      also used to check for fluid or pus
    • Hearing test
      —may be done if you have had many ear infections
    • Tympanocentesis—used to drain fluid or pus from the middle ear using a needle, also used to check for bacteria

  • Prevention

    To reduce the chance of getting an ear infection:

    • Avoid exposure to smoke.
    • Breastfeed your baby for at least the first six months.
    • Try to avoid giving your baby a pacifier.
    • If you bottle-feed, keep your baby's head propped up as much as possible. Don't leave a bottle in the crib with your baby.
    • Get tested for allergies if you or your child have chronic nasal congestion. Keep allergy symptoms well controlled.
    • Treat related conditions, such as GERD.

    • Practice good
      hand washing
    • Make sure your child's vaccinations are up to date.

    • Consider getting a
      flu vaccine
      Pneumococcal vaccine may prevent some ear infections caused by
      but the overall effect on ear infections is not known.
    • If your child has a history of ear infections, talk to the doctor about long-term antibiotic use.
    • Ask your doctor about tympanostomy tubes. These tubes help equalize pressure behind the eardrum and prevent fluid build-up and infection.

  • Risk Factors

    Middle ear infections are more common in the winter. These factors increase your chance of developing middle ear infection:

    • Recent viral infection (eg,
      or flu

    • Recent
    • Age: babies and toddlers
    • Attendance at day care
    • Exposure to second hand smoke, usually cigarette smoke, but also from cooking and wood-heating
    • Babies who are formula-fed

    • Medical conditions that cause abnormalities of the eustachian tubes, such as:

      • Cleft palate
      • Down syndrome

    • History of allergies (environmental allergies,
      food [milk] allergies
    • Gastroesophageal reflux disease (GERD)

    • Babies whose mothers drank
      while pregnant
    • Pacifier use

    Tell your doctor if you have any of these risk factors.

  • Symptoms

    Symptoms include:

    • Ear pain (babies may tug or rub at the ear or face)
    • Fever
    • Irritability
    • Hearing loss (may be only temporary, due to fluid accumulation)
    • Decreased appetite, difficulty feeding
    • Disturbed sleep
    • Drainage from ear
    • Difficulty with balance

  • Treatment

    If you are diagnosed with an ear infection, follow your doctor's