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Ear infection: Symptoms, causes, diagnosis and treatment

 Overview:

Ear infection is quite a common infection affecting children more than adults.They can be caused by fungus, virus or bacteria or may be the result of complications of some infectious or communicable diseases. 

Ear infections may cause discomfort, pain and interfere with your hearing capacity. Most ear infection get resolved within few days to week without any complications. 

If left untreated the ear infections tend to spread into the inner ear causing hearing loss in long run. 

Let us understand more about the ear infections.

In this section, we will see:

  • What is an ear infection?
  • What are the common signs and symptoms of ear infections?
  • What are the causes of ear infections?
  • How is the ear infection diagnosed?
  • How long to take the treatment for ear infection ?
  • Can we prevent ourselves from ear infections?

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What is ear infection?

Our ear consists of three divisions: outer ear, middle ear and inner ear. 

The outer ear is of the part of the ear containing the ear pinna, lobule, helix, auditory canal till the tympanic membrane or ear drum. 

The middle ear is the one contains the air filled space behind tympanic membrane or ear drum consisting three small bones, incus, malleus and stapes.

The inner ear consists of cochlea, vestibule and semicircular canal  Altogether these three parts of ear work in synchronization to let us hear the sounds. 

Ear infections can occur in any part of the ear. Swimmer's ear or fungal infection is the infection of the outer ear.  Acute or chronic otitis media is the middle ear infection. It affects the middle ear.  Infection of the inner ear is called labyrinthitis.

Ear infections (otitis media) are more common in the children.  They are more susceptible to get ear infections till the age of 3 years and even thereafter.  The symptoms of ear infection in children may be different than the adults. 

There are three types of middle ear infection:

  1. Acute otitis media
  2. Chronic suppurative otitis media
  3. Otitis media with effusion of fluid build-up

What are the common signs and symptoms of ear infections?

The common symptoms of ear infection in children are:

  • Pain in the affected ear
  • Pulling or constantly rubbing the ear
  • Unusual crying for more hours
  • Irritability and loss of appetite
  • Unable to sleep or difficulty to sleep 

Seek immediate medical care if :

  • Your child has a high grade fever above 102 degree F.
  • Ear discharge or pus or some fluid is draining out from the ear.
  • Your child cries uncontrollably and the symptoms continue for more than 2-3 days.
  • You feel signs of hearing loss in your child.

The symptoms of ear infection or otitis media in adults:

  • Pain in the ear
  • Pus discharge or fluid in the ear
  • Fluid build up in the middle ear, also called otitis media with effusion
  • Itching and discomfort
  • Hearing problem 

P.S:  The symptoms may vary in different persons and seeking medical advice is always the best alternative. 

What is the function of eustachian tube or canal? 

Eustachian tube plays a major role in preventing ear infections

The eustachian tube is a tube connecting the middle ear to the back of the nose and throat.  

  • The eustachian tube maintains normal pressure into the middle ear 
  • It drains of any extra fluid or secretions formed in the middle ear 
  • Keeps refreshing the air within ear and keeps it dry and fresh.

What are adenoids and what is their role? 
Adenoids are the small masses of soft tissues that lie behind the nasal cavity on each side of the eustachian tube.  They play a major role in immune system. 

Role of adenoids: Adenoids are lymphatic tissue and they play a great role in fighting against the germs.  Any infection may cause them to swell up. The swollen adenoids may interfere with the passage of eustachian tube by blocking it.  This can build up the fluid into the middle ear. It may allow slow drainage of fluid which then can cause ear infections.

What are the causes of the ear infections?

Ear infection can be caused by viruses and bacteria. 

Viruses causing common cold, flu and other respiratory infections can infect your middle ear. 

Bacteria such as hemophilus influenza can also cause middle ear infection

What are the risk factors involved in causing ear infections? 

The following risk factors can cause ear infections:

  • Age of the person: Children in the agre group of 6 months to 3 years are more susceptible to develop ear infections. 
  • Presence or previous history of upper respiratory tract infections: The infections such as common cold and flu are more common to cause ear infection in children and adults. 
  • Bottle feeding the infants:  Ear infection is most common in the babies who are not breastfed. Breastfeeding provides antibodies to fight against common infections. When the baby is bottlefed, there is risk of aspiration pneumonia as well as the blockage of eustachian tube.  This may cause ear infection when the germs start to invade the middle ear. 
  • The babies who are given bottle feeds while lying down are tend to get more ear infections. 
  • Inadequate breastfeeding: The babies who are not breastfeed exclusively may suffer from recurrent ear infections due to the lack of the immunity that your breast milk provides.  Such babies often fall sick due to the viral and bacterial infections.
  • Vaccination:  If the kids are not vaccinated for the major viral and bacterial diseases, the chances of getting ear infections are more.
  • Family history of ear infections: It is believed that the ear infection may run in families the reason of which still remains unclear. This means you are likely to have recurrent ear infections if your parent has had any history of ear infection. Genetic disposition is believed to be a reason but still unexplainable.
  • Smoking and impure air: Smoking can also affect your ear and cause ear infections. Polluted air is a source of respiratory infections and a risk for ear infections.
  • Allergens: Some people are allergic to the pollen, dust animal dander and other allergens that trigger an inflammatory response. This may contribute to cause ear infections. 
  • Swollen adenoids: Adenoids are small pads of tissue in the nose and they are a little large in children than the adults. When they get swollen or inflamed, it may block the Eustachian tubes and cause ear infection.  This may be the one reason why ear infections are common in children than adults.
  • Low immunity levels: It may predispose you to several bacterial and viral infections.
  • Structural deformities: Children with cleft palate may be at more risk of getting ear infections. 

How is ear infection diagnosed?

The ear infection can be diagnosed by visualising the ear parts such as canal and the ear drum with an otoscope and by assessing the symptoms. The ear drum may appear red and bulged if the ear infection is present. The doctor may check for the presence of any sores or redness and the pus or discharge in the ear. 

Other advanced tests such as tympanometry, audiometry are ordered to further assess the condition of the ear drum and hearing capacity to rule out the hearing loss.  

When the ear drum tears or ruptures, it may cause hearing loss which can be mild, moderate, severe or profound.  Audiometry tests can be done to assesss the hearing ability and the range of hearing loss. 

How long to take the treatment for ear infection ?

Any ear infection usually resolves within 72 hours with medical treatment. If the symptoms still persist you must continue the treatment further. Ask your ENT specialist doctor for the progress of recovery. 

How are ear infections treated?

Ear infections can be treated with use of antibiotic medications and ear drops. Antihistamines and other anti-allergic medications may be given to reduce the allergic responses that cause ear infections. 

Ear pus may be drained out using suction and antibiotic ointment may be applied by your otolgist after cleaning up the affected ear. 

How can we prevent ear infections?

Ear infections can be sudden or may develop over time due to the predisposing risk factors.

  • Get yourself and your child properly vaccinated to combat any infections.
  • Exclusively breastfeed your babies till six months and continue up to 2 years to prevent ear infections.
  • Keep the house well ventilated. Quit smoking as it is the major risk factor for respiratory problems. 
  • Take your treatment course fully for any upper respiratory tract infections
  • Do not touch your ear without hand washing
  • Do not insert any objects such as cotton swabs or ear buds into the ear even if it itches. See your doctor if it troubles you more. 
  • Keep your ear clean and dry at all time. After bathing dry it using towel by wiping off any water that is present in the outer ear
  • Avoid bottle feeding if possible. If not, then always bottle feed your baby in upright position. This maintains air pressure in the ear and prevents ear infection. Use a small pillow to elevate the head side of the baby and only then give bottle to your baby and supervise. Do not leave your baby alone with the bottle in cribs.

Seek your doctor's advice before trying out anything on your own. Do not put anything in your ear that may worsen your earache or infections. 

Ear infections can be cured if diagnosed early. They are more common in children than adults. See your doctor if you feel your hearing has been interfered due to the infection.


Note: This post is for informational and educational purpose only, It is not a substitute to any medical or professional advice or treatment. See your doctor in any case.
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