An ear infection (acute otitis media) is often a bacterial or viral infection that affects the middle ear. Ear infections are more likely to occur in children.

Ear infections are often painful due to inflammation and fluid buildup in the middle ear.

Ear infections usually resolve on their own; therefore initial treatment focuses on managing pain and monitoring the condition. Severe infections or infections in infants often require antibiotics. Persistent or frequent ear infections can cause hearing problems or other serious complications.




Symptoms of ear infection in children includes:


  • Ear pain
  • Tugging or pulling at an ear
  • Difficulty sleeping
  • Irritability
  • Frequent crying
  • Difficulty hearing or responding to sounds
  • Loss of balance
  • Fever
  • Drainage of fluid from the ear
  • Headache
  • Loss of appetite



Symptoms of ear infection in adults include:


  • Ear pain
  • Drainage of fluid from the ear
  • Diminished hearing



An ear infection is usually caused by a bacterium or virus in the middle ear. The infection may result from another illness such as a cold, flu or an allergy that causes congestion and swelling of the nasal passages, throat and Eustachian tubes.


Eustachian tubes


The Eustachian tubes are two narrow tubes that run from each middle ear to high in the back of the throat, behind the nasal passages. Inflammation, swelling and mucus in the Eustachian tubes from an upper respiratory infection or allergy can block the tubes causing accumulation of fluids in the middle ear.




Adenoids are small pads of tissues located high in the back of the nose near the opening of the Eustachian tubes. Inflammation or enlargement of the adenoids can block the Eustachian tubes leading to middle ear infection.


Related conditions


Conditions of the middle ear that are associated with ear infections include:


  • Otitis media with effusion: Inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. This may occur due to persistent fluid buildup after an ear infection or dysfunction or noninfectious blockage of the Eustachian tubes.
  • Chronic suppurative otitis media: Persistent ear infection that leads to tearing or perforation of the eardrum.


Risk factors

Factors that increase the risk of ear infections include:


  • Age: Children are more susceptible to ear infections mainly due to the size and shape of their Eustachian tubes or poorly developed immune systems.
  • Group child care: Children in child care are more likely to get ear infections due to frequent exposure to more infections.
  • Seasonal factors: Ear infections occur more commonly during fall and winter when colds and flu are prevalent. People with seasonal allergies may have an increased risk of ear infections during high pollen seasons.
  • Poor air quality: Exposure to tobacco smoke or high levels of air pollution increases the risk of ear infections.



Frequent or persistent infections and persistent fluid build up can cause the following complications:


  • Impaired hearing: Persistent infection or persistent fluids in the middle ear can result in more significant hearing loss. Permanent damage to the eardrum can lead to permanent hearing loss.
  • Speech or developmental delays: Temporarily or permanently impaired hearing in infants and toddlers can cause delays in speech and social and developmental skills.
  • Spread of infection: Untreated infections can spread to nearby tissues.
  • Tearing of the eardrum




  • Prevent common colds and other illnesses
  • Avoid secondhand smoke
  • Breast feeding instead of bottle feeding
  • Vaccinations