Pediatric Middle Ear Infections

Ear infections happen when viruses or bacteria enter the middle ear space behind the eardrum. Middle ear infections (otitis media) occur when the middle ear fills with pus (infected fluid) and puts pressure on the eardrum.

Symptoms of an Ear Infection

Pain in the ear is the primary symptom of an ear infection. Pediatric patients may also experience a fever or trouble eating, drinking, or sleeping. Sucking, chewing, or lying flat may cause pain and pressure. 

Infants and small children may cry more or pull on their ears. Older kids can complain about general ear pain or ear pressure.

As the fluid and pressure build, the eardrum can rupture, with fluid draining from the ear. Fluid pressure is a common cause of ruptured eardrums in children causing dizziness, nausea, or ringing in the ears. 

Why Do Kids Get Ear Infections?

Children aged 2-4 years old may have more infections than older kids and adults. The reason is that their eustachian tubes are shorter, narrower, and more horizontal, allowing more bacteria and viruses into the middle ear more easily. 

Adenoids, the gland-like structures at the back of the throat, can interfere with opening the eustachian tubes. Other factors can cause more ear infections, including secondhand smoke, bottle-feeding, and exposure to other children. Ear infections are not contagious, but colds that can cause them can be. Ear infections are more common in boys than girls.

How Long Do Ear Infections Last?

Usually, middle ear infections will last 2 or 3 days without treatment and six weeks or longer with fluid in the middle ear. 

How Are Ear Infections Diagnosed?

Pediatric ENT providers (ENT Physicians or Advanced Practice Providers) diagnose ear infections using an otoscope, a small instrument similar to a flashlight, to see the eardrum.


An ENT Specialist may treat ear infections by waiting to see how they progress, heal naturally, or by using pain medication such as acetaminophen or ibuprofen. Your doctor also may recommend using pain-relieving ear drops as long as the eardrum isn’t ruptured.

Antibiotics are usually not prescribed. Antibiotics do not treat infections caused by viruses, do not reduce fluid, may cause side effects, and do not relieve pain. An ENT Specialist may prescribe antibiotics to treat recurring ear infections.

Can Ear Infections Affect Hearing?

Fluid buildup in the middle ear can lead to temporary hearing problems. 

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