What is an ear infection?

Ear infections are the most common reason parents bring their child to see a doctor. Three out of four children will have at least one ear infection by their third birthday. Adults can also get ear infections, but they are less common.

An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear, and often begins after a child has a sore throat, cold, or other upper respiratory infection.

If the upper respiratory infection is bacterial, these same bacteria may spread to the middle ear.  If the upper respiratory infection is caused by a virus, such as a cold, bacteria may be drawn to the microbe-friendly environment and move into the middle ear as a secondary infection.

Because of the infection, the tubes inside the ears become clogged with fluid and mucus which can affect hearing, because sound cannot get through all that fluid. Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.

Your healthcare provider will diagnose an ear infection by looking inside the ear with an instrument called an otoscope. Often, ear infections go away on their own, but it is important to have your child seen by a doctor to be sure.

If your child isn’t old enough to say “my ear hurts” here are a few things to look for:

-Tugging at ears

-Crying more than usual

-Fluid draining from the ear

-Trouble sleeping

-Balance difficulties

-Hearing problems

There are three main types of ear infections. Each has a different combination of symptoms:

Acute otitis media (AOM) is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the ear—commonly called an earache. Your child might also have a fever.

Otitis media with effusion (OME) sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument.

-Chronic otitis media with effusion (COME) happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing.

Why are children more likely than adults to get ear infections?

There are several reasons why children are more likely than adults to get ear infections.

Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain.

Additionally, a child’s immune system isn’t as effective as an adult’s because it’s still developing. This makes it harder for children to fight infections.

Parts of the ear

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