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Otitis Media

Published on March 5, 2025 at 8:00 / Updated on March 19, 2025 at 8:00

(Middle ear infection)

Otitis media is an infection of the middle ear, which is the area behind the eardrum. It should not be confused with otitis externa, also known as an outer ear infection or swimmer's ear, as it is common in the summer and among swimmers.

Causes and triggers

While a middle ear infection can occur at any age, it is most common in children aged between a few months and 3 years. Their Eustachian tubes, which are the canals that connect the middle ear to the throat, are immature and do not yet function properly. Because the Eustachian tubes have less of a slope, fluid does not drain as well as it should, making it easier for bacteria to develop and make its way to the middle ear.

Ear infections can occur at any time of the year, but since they often develop after a cold or the flu, there are many more cases in the winter. Children in daycare are more at risk.

Symptoms

Symptoms include pain in the infected ear, often accompanied by fever, and at times by nausea and diarrhea, especially in very young children. Many individuals also experience hearing loss. Symptoms in infants include irritability or difficulty sleeping.

Sometimes, pressure in the eardrum can cause it to rupture, causing pus to drain from the ear. The perforation from a rupture usually heals quickly and without need for further treatment.

Treatment

Acetaminophen (e.g., Tylenol, Tempra) or ibuprofen (e.g., Motrin, Advil) can be used to relieve pain and fever. Antibiotics may also be prescribed. While most children feel better after 2 or 3 days, the antibiotic treatment must be continued until the end.

When ear infections are recurrent, a health care provider may insert a tiny tube in the eardrum. The goal of this procedure is to prevent fluid from accumulating in the middle ear, thereby reducing the frequency of ear infections.

The following measures may help reduce the risk of developing otitis media:

  • Maintain a smoke-free environment
  • Get routine and flu vaccines
  • Wash hands carefully and frequently, especially during cold and flu season
  • Blow the nose more often in case of cold or flu
  • In infants:
    • Having been breastfed for at least 6 months
    • Avoid feeding in a lying position
    • Avoid pacifiers

When should I see a health care professional?

Consult your health care provider in the following cases:

  • A child under 6 months of age with fever
  • A drowsy and fussy child, losing appetite
  • A fever persisting despite acetaminophen or ibuprofen
  • A fever higher than 39°C
  • Symptoms lasting for more than 2 or 3 days
  • Fluid discharge from the ear
  • Decreased hearing
  • Loss of balance
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