Middle Ear Infection or Inflammation (Otitis Media)

  • 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

How do you get a middle ear infection?

Bacteria and viruses can cause middle ear infections. Bacteria such as Streptococcus pneumoniae (pneumococcus), Hemophilus influenzae, Pseudomonas, and Moraxella account for about 85% of cases of acute otitis media. Viruses account for the remaining 15%. Affected infants under six weeks of age tend to have infections from a variety of different bacteria in the middle ear.

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

  • Bottle-feeding: The position of the breastfeeding child is better than that of the bottle-feeding position in terms of the function of the Eustachian tube that leads into the middle ear. If a child needs to be bottle-fed, it is best to hold the infant rather than allow the child to lie down with the bottle. Ideally, the child should not take the bottle to bed. (In addition to increasing the chance for acute middle ear 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 acute middle ear 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, also increases the chance of otitis media.
  • 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 otitis media. Individuals with allergies may get 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 otitis media before six months of age tend to have more ear infections later in childhood.

How does the Eustachian tube change with age?

As a person ages, the Eustachian tube doubles in length and becomes more vertically positioned so that the nasopharyngeal orifice (opening) in the adult, is significantly below the tympanic orifice (the opening in the middle ear near the ear drum) than in a child. The greater length and particularly the slope of the tube as it grows serves more effectively to protect, aerate and drain the middle ear.

Medically Reviewed by a Doctor on 8/3/2016

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