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How To Tell If Ear Infection

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Ear infections can go away on their own in many cases, so a minor earache may not be a worry.

A doctor should typically be seen if symptoms have not improved within 3 days. If new symptoms occur, such as a fever or loss of balance, a doctor should be seen immediately.

Any sign of discharge coming from the ear would also require a visit to the doctor.

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Signs That You Have An Ear Infection

Ear infections are one of the most uncomfortable common illnesses. They frequently appear in children, but they can occur in adults, too, especially if you wear hearing aids. Here are fifteen signs that you have an ear infection.

1. Pain in the ear

One of the first things most people notice is a pain in the ear. Earache can be dull and throbbing or sharp and stabbing. Some people experience ear infection pain as a burning sensation. Ear infection pain doesnt usually last longer than three days.

2. Headaches

Some ear infections can cause headaches. Blockages in the ear, such as from infection, could account for your headache. If an object or impacted wax is blocking your ear, though, this could be the problem instead.

3. Nausea and vomiting

Ear infections are often accompanied by nausea , loss of appetite, and vomiting. If you are vomiting, try to stay hydrated by taking small sips of water. Call your doctor if the vomiting doesnt stop.

4. Dizziness

The ears are the bodys center of balance. Some types of ear infections affect your balance and cause dizziness and vertigo. It may feel like things are moving or spinning. Be extra careful when youre standing, walking, or driving.

5. Itchiness

Itching is one of the many signs of an ear infection. It can be in the ear canal itself, or on the lobe or outer ear. Its always best to refrain from scratching where possible, as you dont want to spread the infection or irritate your ear more.

6. Scaly skin in the ear

How To Tell If My Ear Infection Is Getting Better Or Worse

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What Causes Inner Ear Infections

Infections can happen in any part of the ear, including the inner section. When the inner ear is infected, the problem is sometimes known as labyrinthitis.

The infection can be caused by a virus or bacteria, which usually reach the inner ear after affecting another part of your body.

  • Viral Infections: Lots of different viruses can affect the inner ear, including the common cold and flu. The infection usually spread to the inner ear from other parts of the body , so you may start to develop symptoms related to your inner ear after noticing cold-like symptoms. Antibiotics cant help with this type of infection.
  • Bacterial Infections: Bacterial infections are less common, especially in adults, but they can happen. Bacteria are more likely to get into the inner ear if the membranes separating it from the inner ear are broken, which might happen if you have a middle ear infection. If the infection is caused by bacteria then taking antibiotics might help.

In some cases, the problem that we call an inner ear infection isnt actually an infection at all. Labyrinthitis can happen when the inner ear becomes inflamed for other reasons, for example if you have an autoimmune condition that causes your immune system to mistakenly attack the tissue. You might need to get treatment for this underlying condition in order to prevent the inner ear problems from returning.

What Causes Middle Ear Infections

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Most middle ear infections occur when an infection such as a cold, leads to a build-up of mucus in the middle ear and causes the Eustachian tube to become swollen or blocked.

This mean mucus can’t drain away properly, making it easier for an infection to spread into the middle ear.

An enlarged adenoid can also block the Eustachian tube. The adenoid can be removed if it causes persistent or frequent ear infections. Read more about removing adenoids.

Younger children are particularly vulnerable to middle ear infections as:

  • the Eustachian tube is smaller in children than in adults
  • a child’s adenoids are relatively much larger than an adults

Certain conditions can also increase the risk of middle ear infections, including:

  • having a cleft palate a type of birth defect where a child has a split in the roof of their mouth
  • having Down’s syndrome a genetic condition that typically causes some level of learning disability and a characteristic range of physical features

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Can Middle Ear Infections Be Prevented

It’s not possible to prevent middle ear infections, but there are some things you can do that may reduce your child’s risk of developing the condition. These include:

  • make sure your child is up-to-date with their routine vaccinations particularly the pneumococcal vaccine and the DTaP/IPV/Hib vaccine
  • avoid exposing your child to smoky environments
  • don’t give your child a dummy once they’re older than six to 12 months old
  • don’t feed your child while they’re lying flat on their back
  • if possible, feed your baby with breast milk rather than formula milk

Avoiding contact with other children who are unwell may also help reduce your child’s chances of catching an infection that could lead to a middle ear infection.

How To Help Prevent Ear Infections

While most children get ear infections, there are a few things parents can do to try to prevent them:

  • Breast feeding infants until at least age 6 months may help to lessen the number of ear infections.
  • Keep your child away from cigarette smoke. Do not smoke or allow smoking in your home or car.
  • Always hold your baby with his head up during feeding time . Babies should not be fed by propping the bottle or while lying flat.The formula can get into the middle ear and cause an infection.
  • Do notleave a bottle in the crib for the baby to drink at bedtime.
  • Make sure your childs immunizations are up to date.
  • If your child is diagnosed with acute otitis media, avoid giving him a pacifier.Dress your child properly in cold and rainy weather.

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Symptoms Of A Middle Ear Infection

In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:

  • a lack of energy
  • slight hearing loss – if the middle ear becomes filled with fluid

In some cases, a hole may develop in the eardrum and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

How Is An Ear Infection Treated

How To Spot Symptoms Of An Ear Infection

Treatment of ear infections depends on age, severity of the infection, the nature of the infection and if fluid remains in the middle ear for a long period of time.

Your healthcare provider will recommend medications to relieve you or your childs pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.

Antibiotics

Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection. Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your childs ear infection is severe, antibiotics might be started right away.

The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your childs age, severity of their infection, and your childs temperature. Their recommendations are shown in the table below.

American Academy of Pediatrics Treatment Guide for Acute Otitis Media

Childs Age
in one or both ears Mild for < 48 hours and temp < 102.2° F Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesnt improve within 48 to 72 hours of start of symptoms

Pain-relieving medications

Ear tubes

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How Middle Ear Infections Are Treated

Most ear infections clear up within three to five days and don’t need any specific treatment. If necessary, paracetamol or ibuprofen should be used to relieve pain and a high temperature.

Make sure any painkillers you give to your child are appropriate for their age. Read more about giving your child painkillers.

Antibiotics aren’t routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.

Read more about treating middle ear infections

Signs Of Otitis Externa

Otitis externa is an inflammation of the external section of the ear canal, which does not reach the eardrum. Most cases are caused by bacteria.

Signs and symptoms can include:

  • Itchiness of the ear

If you are concerned that you may have an outer ear infection, try using the Ada app to find out what the problem may be.

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Where Is The Middle Ear

The middle ear is behind the eardrum and is also home to the delicate bones that aid in hearing. These bones are the hammer , anvil and stirrup . To provide the bigger picture, lets look at the whole structure and function of the ear:

The ear structure and function

There are three main parts of the ear: outer, middle and inner.

  • The outer ear is the outside external ear flap and the ear canal .
  • The middle ear is the air-filled space between the eardrum and the inner ear. The middle ear houses the delicate bones that transmit sound vibrations from the eardrum to the inner ear. This is where ear infections occur.
  • The inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.

Other nearby parts

  • The eustachian tube regulates air pressure within the middle ear, connecting it to the upper part of the throat.
  • Adenoids are small pads of tissue above the throat and behind the nose and near the eustachian tubes. Adenoids help fight infection caused by bacteria that enters through the mouth.

Healing Time In Different Sections Of The Ear

Ear infections in babies

The infections persist in the middle, the outer and inner part of the ear. Every part has its unique features. As a result healing time also depends on the section of the ear.

  • Outer Causes of outer ear infection are different from a middle ear infection. The most common type of infection in the outer ear is bacterial infections. But fungal and viral infections can occur as well. It can last for a week or longer. Its symptoms are severe pain in the ear, purulent discharge, fever, etc.
  • Middle The infection shouldnt last more than one or two days. After an ear infection clears up, fluid may remain in the middle ear and cause some of the more mild symptoms and can persist for several weeks to months. This condition is diagnosed as otitis media with effusion. Its symptoms are ear pain, feeling like your ear is clogged, Nausea, Reduced Hearing.
  • Inner The infection exists for a long time in this section. Most commonly, viral is the reason for the inner ear infection. These viruses can be most of the flu and cold. Its symptoms are pain, fever, and reduced hearing. Nausea and tinnitus can also occur in an inner ear infection.

The Eustachian tube drains fluid and air from the middle ear. Blockage in the Eustachian tube may cause fluid to build up. This causes pain since it applies pressure on the eardrum. The fluid is also a fertile ground for bacteria growth and this leads to an ear infection.

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Can Ear Infections Be Prevented

Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.

  • Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
  • It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
  • Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
  • Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
  • Never put your baby down for a nap, or for the night, with a bottle.
  • Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.

What Causes An Ear Infection In Adults

Ear infections in the outer canal are caused by:

  • Bacterial or fungal overgrowth in the ear canal that results from moisture mixing with the earwax and debris in the ear canal
  • Moisture can enter the ear canal from swimming, diving, or even bathing
  • Overuse of cotton swabs in the ear canal

Ear infections in the middle ear are caused by:

  • Bacteria
  • Common bacterial causes of middle ear infections are Streptococcus pneumoniae , Haemophilus influenzae, and Moraxella catarrhalis
  • Viruses
  • Common viral causes of middle ear infections are respiratory syncytial virus and flu virus
  • Fluid from the sinuses can back up through the Eustachian tubes that connect the throat to the middle ear, such as when the sinuses or throat are inflamed from infection
  • The backed-up fluid becomes trapped in the middle ear, which is a good breeding ground for bacteria and viruses
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    How Do Ear Infections Happen

    A middle ear infection usually happens because of swelling in one or both of the eustachian tubes . The tubes let mucus drain from the middle ear into the throat.

    A cold, throat infection, acid reflux, or allergies can make the eustachian tubes swell. This blocks the mucus from draining. Then, or grow in the mucus and make pus, which builds up in the middle ear.

    When doctors refer to an ear infection, they usually mean otitis media rather than swimmer’s ear . Otitis media with effusion is when noninfected fluid builds up in the ear. It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or “popping.”

    How Is An Acute Middle Ear Infection Treated

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    Many doctors will prescribe an antibiotic, such as amoxicillin, to be taken over seven to 10 days. Your doctor also may recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or eardrops, to help with fever and pain.

    If your doctor isnt able to make a definite diagnosis of OM and your child doesnt have severe ear pain or a fever, your doctor might ask you to wait a day or two to see if the earache goes away. The American Academy of Pediatrics issued guidelines in 2013 that encourage doctors to observe and closely follow these children with ear infections that cant be definitively diagnosed, especially those between the ages of 6 months to 2 years. If theres no improvement within 48 to 72 hours from when symptoms began, the guidelines recommend doctors start antibiotic therapy. Sometimes ear pain isnt caused by infection, and some ear infections may get better without antibiotics. Using antibiotics cautiously and with good reason helps prevent the development of bacteria that become resistant to antibiotics.

    If your doctor prescribes an antibiotic, its important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still hasnt completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. Its also important to return for your childs follow-up visit, so that the doctor can check if the infection is gone.

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    Check If It’s An Ear Infection

    The symptoms of an ear infection usually start quickly and include:

    • discharge running out of the ear
    • a feeling of pressure or fullness inside the ear
    • itching and irritation in and around the ear
    • scaly skin in and around the ear

    Young children and babies with an ear infection may also:

    • rub or pull their ear
    • not react to some sounds
    • be irritable or restless
    • be off their food
    • keep losing their balance

    Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.

    Differences between middle and outer ear infections

    Inner ear infection Middle ear infection Outer ear infection
    Can affect both children and adults Usually affects children Usually affects adults aged 45 to 75
    Caused by viral or bacterial infections Caused by viruses like colds and flu Caused by something irritating the ear canal, such as eczema, water or wearing earplugs
    Affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis Affects the eustachian tube, which connects the middle ear to the back of the nose Affects the ear canal

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