What are the typical symptoms?
- Throbbing or stabbing earache, often worse at night
- Pressure and muffled hearing in the affected ear
- Fever and feeling generally unwell
- In young children: crying, restlessness, pulling at the ear, poor sleep, reluctance to drink
- Fluid or pus running from the ear if the eardrum has perforated – the pain often eases suddenly when this happens
How is a middle ear infection diagnosed?
The appointment starts with questions about how long the symptoms have lasted, fever, a recent cold and earlier ear infections. The eardrum is then examined with the ear microscope: redness, bulging or fluid behind it point to an infection.
A test of eardrum mobility (tympanometry) and a hearing test may be added. The nose and throat are examined as well, because enlarged adenoids often play a part in repeated ear infections in children.
How is it treated?
Many acute middle ear infections settle within a few days. The focus is on relieving pain and fever and, where advised by the doctor, decongesting the nose.
Antibiotics are not needed in every case. Whether they are used depends on the findings, age, how severe the symptoms are and how they develop – this is discussed together at the examination. A check-up after a few weeks makes sense if hearing stays muffled.
When is urgent help needed?
Swelling or redness behind the ear or an ear that sticks out, facial weakness, severe dizziness, severe headache, a stiff neck, drowsiness or high fever in a baby need immediate medical care – call 144 in an emergency (112 across the EU).
Repeated ear infections and glue ear
If ear infections happen several times a year, or fluid stays behind the eardrum afterwards (glue ear), contributing factors are looked for, such as enlarged adenoids, allergies or poor ventilation of the Eustachian tube. In children, hearing and speech development are checked as well; if a procedure could help, a referral to a hospital is arranged.