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Anatomy of an Ear Infection

Ear infections are extremely common, especially in runny-nosed kids. The latest research indicates that when young children get colds, they end up with an ear infection 61% of the time. Keep reading to find out why.
Diagnosing an Ear Infection
Doctors usually diagnose an ear infection by looking at the outer ear and the eardrum with a device called an otoscope. A healthy eardrum (shown here) appears transparent and pinkish-gray. An infected eardrum looks red and swollen.
Anatomy of an Inner Ear Infection
The Eustachian tube is a canal that connects the middle ear to the throat. It is lined with mucus, just like the nose and throat; it helps clear fluid out of the middle ear and into the nasal passages. Cold, flu, and allergies can irritate the Eustachian tube and cause the lining of this passageway to become swollen.
Fluid in the Ear
If the Eustachian tube becomes blocked, fluid builds up in the middle ear. This creates a haven for bacteria and viruses, which can cause infection. Doctors can detect fluid in the middle ear with a pneumatic otoscope. This device blows a small amount of air at the eardrum, making the eardrum vibrate. If fluid is present, the eardrum will not move as much as it should.
Ruptured Eardrum
When too much fluid builds up in the middle ear, it can put pressure on the eardrum until it ruptures (shown here). Signs of a ruptured eardrum include yellow, brown, or white fluid draining from the ear. Pain may disappear suddenly because the pressure of the fluid on the eardrum is gone. Although a ruptured eardrum sounds frightening, it usually heals itself in a couple of weeks.
Ear Infection Symptoms
The hallmark of an acute ear infection is sudden, piercing pain in the ear. The pain may be worse when lying down, making it difficult to sleep. Other symptoms include:
Trouble hearing.
A fever of up to 104 degrees.
Tugging or pulling at one or both ears.
Fluid drainage from ears.
Loss of balance.
Nausea, vomiting, or diarrhea.
Ear Infection Symptoms: Babies
It can be tricky to identify an ear infection in babies or children who are too young to tell you where it hurts. Signs to watch for are crankiness, trouble sleeping, and loss of appetite. Babies may push their bottles away because pressure in the middle ear makes it painful to swallow.
Home Care for Ear Infections
Although the immune system puts up its fight, you can take steps to ease the pain of an ear infection. Applying a warm washcloth or heating pad can be soothing. (Only use a heating pad if your child is old enough to say when it's too hot.) Ear drops provide rapid pain relief, but check with your doctor before using them. Over-the-counter painkillers, such as ibuprofen and acetaminophen, are also an option. DO NOT give aspirin to children under 16.
Antibiotics for Ear Infections
Antibiotics can cure an ear infection, but research suggests treatment is not always necessary. In most cases, children's immune systems can fight off the infection without help. In one study, parents were asked not to give their child antibiotics unless the infection was “not better, or worse” after 48 hours. The delay resulted in far fewer kids taking antibiotics.
Complications of Ear infections
If an ear infection doesn't improve on its own after a couple days, medical treatment is essential. Left untreated, severe and recurrent middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, speech and language developmental problems, and meningitis. A hearing test may be needed if you child suffers from frequent ear infections.
Ear Tubes
If your child has recurrent ear infections or fluid that just won't go away, hearing loss and a delay in speech may be a real concern. One solution is for your doctor to insert small tubes through the eardrum. Ear tubes let fluid drain out of the middle ear and prevent fluid from building back up. This can decrease pressure and pain, while restoring hearing. The tubes are usually left in for 8 to 18 months until they fall out on their own.
Surgery to Remove the Adenoids
Adenoids are lymph nodes located high in the back of the throat. They can become enlarged from repeated ear infections and can affect the Eustachian tubes that connect the middle ears and the back of the nose. An adenoidectomy (removal of the adenoids) may help children with recurring ear infections have fewer of them. Adenoidectomy is typically done when recurring ear infections continue despite antibiotic treatment.
Preventing Ear Infections
The biggest cause of ear infections is the common cold, so one strategy for prevention is to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing. Other lines of defense against ear infections include avoiding secondhand smoke and breastfeeding your baby for the first year of life.
Allergies & Ear Infections
Like colds, allergies can irritate the Eustachian tubes and contribute to middle ear infections. Getting allergies under control can help reduce frequent ear infections.
Swimmer's Ear
Swimmer's ear is an infection that occurs when water is trapped in the external ear canal. Bacteria breed in the water and cause pain, swelling, and itching of the outer ear. Although it's often associated with swimming, anyone can get swimmer's ear. The condition is usually treated with ear drops and is not a cause of middle ear infections.

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