Middle Ear Infection In Infants, Toddlers, Children, and Adults

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Author: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideEar Infection Symptoms, Causes, and Treatment

Ear Infection Symptoms, Causes, and Treatment

Signs and symptoms of acute middle ear infection in infants, toddlers, and children

Signs and symptoms of middle ear infections in babies, toddlers, and children may include:

  • Young non-verbal children may be irritable and pull or tug at their ear(s).
  • Young children with middle ear infections may be irritable, fussy, or have problems feeding or sleeping.
  • Older children may complain about pain and fullness in the ear (earache).
  • A child of any age may have a fever.
  • The buildup of pus within the middle ear causes pain and dampens the vibrations of the eardrum (so there is usually temporary hearing loss during the infection).
  • Severe ear infections may cause the eardrum to rupture. The pus then drains from the middle ear into the ear canal.
  • The hole in the eardrum from the rupture usually heals without medical treatment.

These symptoms are often associated with signs of upper respiratory infection such as a runny or stuffy nose, or a cough.

Signs and symptoms of middle ear infections in adults

and symptoms in adults may have one or more of the following:

How common is acute middle ear infection or inflammation?

This type of infection is an extremely common diagnosis. In the U.S. it is estimated that 75% of all children experience at least one middle ear infection before the age of three.

Are ear infections contagious?

Ear infections are not contagious. However, many children develop infections following a cold or other viral infection, and those infections are contagious.

Why do infants and young children tend to have ear infections?

The Eustachian tube, a canal that runs from the middle ear to the back of the nose and throat, is shorter and more horizontal in infants and young children than in older children and adults. This allows easier entry into the middle ear for the microorganisms that cause infection and lead to otitis media. Young children also have more immature immune systems. The result is that infants and young children are at greater risk of acquiring ear infections than adults.

What are the risk factors for acute and middle ear infection?

  • Bottlefeeding: The position of the breastfeeding child is better than that of the bottlefeeding position in terms of the function of the Eustachian tube that leads into the middle ear. If an infant needs to be bottlfed, it's better to hold the the baby rather than allowing them to lie down with the bottle. Ideally, they should not take the bottle to bed. (In addition to increasing the chance for acute infection, falling asleep with milk in the mouth enhances the risk of tooth decay.)
  • Upper respiratory tract infection: Children often develop upper respiratory infections prior to developing this type of infection. Exposure to groups of children (as in child care centers) results in more frequent colds, and therefore more earaches.
  • Exposure to air with irritants, such as tobacco smoke
  • Birth defects: Children with cleft palate or Down syndrome are more prone to ear infections.
  • Eustachian tube problems: Any problems with the Eustachian tubes (for example, blockage, malformation, inflammation) will increase the risk of infection. If the individual has allergies he or she may have swelling and blockage of one or both Eustachian tubes.
  • Immunosuppressed: Individuals with suppressed immunosuppression are at increased risk for ear infections.
  • Ear infections later in childhood: Children who have episodes of acute infections before six months of age tend to have more later in childhood.
Medically Reviewed by a Doctor on 3/16/2017

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