Ear Infection (Otitis Media)
التهاب الأذن الوسطى
An infection of the middle ear, most common in young children, causing ear pain, difficulty hearing, and sometimes fever or fluid drainage. Many cases improve on their own within a few days; persistent or severe cases, or those in very young infants, may need antibiotics.
This information is for general awareness only and does not replace professional medical advice. Consult a doctor for diagnosis and treatment.
Quick answer
A middle-ear infection (otitis media) is an infection of the space behind the eardrum. It is very common in children and often follows a cold, when fluid gets trapped and becomes infected.
The main symptoms are ear pain, a high temperature, and reduced hearing; young children may pull at the ear, be irritable, or feed poorly.
Most ear infections clear up within a few days, and pain relief is the main treatment. Antibiotics are used only for some cases, based on age and severity. See a doctor if symptoms are severe, last more than a few days, or discharge from the ear appears.
Symptoms
Ear pain
Sometimes severe, and often worse at night or when lying down.
High temperature
Reduced hearing
Sounds may seem muffled.
Feeling of fullness or pressure in the ear
Discharge from the ear
If the eardrum has burst, pain often eases.
In young children: pulling at the ear, irritability, poor feeding, restless sleep
Loss of balance or vomiting
Symptom guides
Causes and risk factors
Causes
- Bacterial or viral infection — Often follows a cold, flu or throat infection.
- Blocked Eustachian tube — The tube connecting the ear to the back of the nose is short and narrow in children, so fluid drains poorly.
- Enlarged adenoids — Can block or affect the Eustachian tube.
Risk factors
- Age under 5 — Most common between 6 months and 3 years.
- Recent cold or upper respiratory infection
- Attending nursery or group childcare
- Exposure to tobacco smoke
- Bottle feeding while lying down
- Allergies
- Cleft palate or Down syndrome
How is it diagnosed?
A doctor diagnoses ear infection by looking at the eardrum and considering your symptoms.
Symptoms and history
Ear pain, fever, recent colds and hearing changes.
Otoscopy
A lighted instrument shows a red, bulging or draining eardrum.
Hearing tests
Considered if hearing loss persists or infections recur.
Treatment
Many ear infections settle on their own in about three days. Treatment focuses on pain relief; a doctor decides whether antibiotics are needed based on the child's age and how ill they are.
Pain and fever relief
Simple analgesics at doses appropriate for age, as advised by a doctor or pharmacist.
Watchful waiting
Often appropriate in older children with mild illness.
Antibiotics
For younger children, severe or persistent illness, or discharge; prescribed and dosed by a doctor.
Referral to an ENT specialist
For recurrent infections or persistent fluid with hearing loss, where ear tubes (grommets) may be considered.
Do not put anything into the ear, such as drops or cotton buds, unless a doctor advises it.
When should you see a doctor?
Arrange a medical assessment if
- Symptoms lasting more than three days or getting worse
- Discharge or pus from the ear
- A baby under 6 months with ear symptoms or fever
- Repeated ear infections
- Hearing or speech delay concerns in a child
Seek urgent care if
- Swelling, redness or tenderness behind the ear
- Stiff neck, severe headache, drowsiness or confusion
- Facial weakness or drooping
- High fever in a child who seems very unwell
Prevention
Vaccinations
Keep childhood vaccinations up to date, including pneumococcal and annual flu vaccines.
Avoid tobacco smoke around children
Breastfeed if possible
It may reduce the risk in infants.
Don't bottle-feed a baby lying flat
Wash hands to reduce colds
Frequently asked questions
What is a middle-ear infection?
An infection of the air-filled space behind the eardrum.
Why are children more prone to ear infections?
Their Eustachian tubes are shorter and more horizontal, so fluid drains poorly, and they catch many colds.
Are ear infections contagious?
The colds that trigger them are contagious, but the ear infection itself is not spread from person to person.
Do ear infections need antibiotics?
Not always. Many settle without them; a doctor will decide depending on age, severity and duration.
Can ear infections affect hearing?
Temporarily, yes. Persistent fluid behind the eardrum can cause lasting hearing problems that need assessment.
What about swimmer's ear?
That is an infection of the outer ear canal (otitis externa), a different condition usually treated with ear drops.
Related specialties
Related conditions
Related articles
Looking for a doctor?
Find a specialist who treats this condition, and compare profiles before you book.
Medical sources
This page summarizes general information from the sources below.