How Do Ear Infections Happen

What Is The Most Frequent Type Of Ear Infection In Adults

Dr. Wang: An outer ear infection, or otitis externa, is the type we most frequently encounter in adults. These can strike anyone at any age, with or without a history of ear infections. Outer ear infections are also known as swimmer’s ear, because they are typically caused by the introduction of moisture from outside the body. The ear canal is a warm, moist area of the body, the perfect breeding ground for bacterial or fungal growth and an easy entry point for moisture to enter. Adults who are more predisposed to getting otitis externa include those with eczema of the ear canal and those who frequently insert cotton swabs into their ear canal.

What Research Is Being Done On Middle Ear Infections

Researchers sponsored by the National Institute on Deafness and Other Communication Disorders are exploring many areas to improve the prevention, diagnosis, and treatment of middle ear infections. For example, finding better ways to predict which children are at higher risk of developing an ear infection could lead to successful prevention tactics.

Another area that needs exploration is why some children have more ear infections than others. For example, Native American and Hispanic children have more infections than do children in other ethnic groups. What kinds of preventive measures could be taken to lower the risks?

Doctors also are beginning to learn more about what happens in the ears of children who have recurring ear infections. They have identified colonies of antibiotic-resistant bacteria, called biofilms, that are present in the middle ears of most children with chronic ear infections. Understanding how to attack and kill these biofilms would be one way to successfully treat chronic ear infections and avoid surgery.

Understanding the impact that ear infections have on a childs speech and language development is another important area of study. Creating more accurate methods to diagnose middle ear infections would help doctors prescribe more targeted treatments. Researchers also are evaluating drugs currently being used to treat ear infections, and developing new, more effective and easier ways to administer medicines.

Why Dont Doctors Give Antibiotics For Middle Ear Infections Just In Case

Often, the infection will go away by itself after about 4 days. On average, children who take antibiotics have ear pain for only about 12 hours less than children who dont take antibiotics.

On the other hand, if antibiotics are prescribed, some children will have side effects. Using antibiotics can also cause bacteria to become resistant to them, meaning that the antibiotics might not work in future.

For these reasons, antibiotics are not generally recommended for middle ear infections unless your child is at risk of developing complications. For more information, speak to your doctor or visit the Australian Commission on Safety and Quality in Health Care website.

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What Are Recurrent Ear Infections

People of all ages can get frequent ear infections, but they are especially common in children about 25% of children experience repeat ear infections. If you or your child has three or more ear infections in a six-month period or four within one year, its a good idea to talk to your doctor about treatment options.

Are recurrent ear infections curable?

Your doctor may recommend ear tube surgery to make it less likely for you or your child to get future ear infections.

Your doctor may also suggest a tonsillectomy to remove infected tonsils and adenoids. This surgery involves removing lumps of tissue from the back of your nose and throat. Getting a tonsillectomy may make it easier for fluid to drain from your ears, reducing the chance of trapped fluid that can cause an ear infection. A tonsillectomy is usually only recommended when antibiotics and ear tubes dont work.

What Causes A Urinary Tract Infection

Urinary tract infections are caused by microorganisms usually bacteria that enter the urethra and bladder, causing inflammation and infection. Though a UTI most commonly happens in the urethra and bladder, bacteria can also travel up the ureters and infect your kidneys.

More than 90% of bladder infection cases are caused by E. coli, a bacterium normally found in the intestines.

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How To Prevent Ear Infections And Fluid In The Ears

• Frequently Asked Questions

Ear infections can be painful and disruptive. They are especially frustrating for people who get reoccurring ear infections, or for parents whose children are prone to them.

Approximately 80% of children will experience at least one episode of the middle ear infection acute otitis media by their third birthday. About 40% will have six or more recurrences of AOM by the time they reach 7 years old.

Although AOM occurs most often in children, a 2005 global study showed adults ages 25 to 85 accounted for 1.5% to 2.3% of incidences of AOM.

Thankfully, the rate of AOM has declined in the years since 2000 in the United States and some other countries, likely due to the introduction of the pneumococcal vaccine and an understanding of other preventative measures, which are covered in the article below.

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The Role Of Eustachian Tubes

The eustachian tubes connect the middle ear to the back of the throat. The ends of these tubes open and close to regulate air pressure in the middle ear, resupply air to this area, and drain normal secretions.

A respiratory infection or allergy can block the eustachian tubes, causing a buildup of fluids in the middle ear. Infection can occur if this fluid becomes infected bacterially.

The eustachian tubes of young children are smaller and more horizontal than in older children and adults. This means that fluid is more likely to collect in the tubes rather than drain away, increasing the risk of an ear infection.

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Where Can I Find Additional Information About Ear Infections

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on ear infections:

Can Ear Infections Be Prevented

Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.

• Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
• It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
• Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
• Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
• Never put your baby down for a nap, or for the night, with a bottle.
• Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.

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Can You Get An Outer Ear Infection From Sweating A Lot When You Work Out

Dr. Wang: It’s not common, but yes. It’s called swimmer’s ear because that is what usually causes it. But moisture can also be introduced into the ear from showering, taking a bath, rain or sweat dripping into your ear even high humidity. Outer ear infections are mostly caused by bacteria, but they can also be caused by fungus, such as the fungus that causes athlete’s foot.

When Is An Ear Infection Considered To Be Chronic

If an ear infection lasts for more than three months, its considered chronic. If chronic ear infections arent treated, it can lead to hearing loss and other serious problems. In children, chronic ear infections can affect their ability to achieve developmental milestones, like walking and talking.

Is a chronic ear infection curable?

If your child has an ear infection for a few months and its affecting their ability to hear, your doctor may recommend a minor surgery to put in ear tubes for chronic ear infections.

During ear tube surgery, an ear, nose and throat doctor inserts small plastic or metal tubes into the eardrum. These tubes help drain the built-up fluid that can cause ear infections. Ear tubes usually fall out on their own within about a year.

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Where To Get Help

• NURSE-ON-CALL Tel. for expert health information and advice
• Royal Children’s Hospital Tel. 9345 5522
• Your maternal and child health nurse
• Your local hospital emergency or casualty department.
• 24 hour Maternal and Child Health Telephone Service: Tel. 13 22 29 for the cost of a local call throughout Victoria.

What Are The Symptoms Of Otitis Media

Symptoms of ear infection include:

• Ear pain: This symptom is obvious in older children and adults. In infants too young to speak, look for signs of pain like rubbing or tugging ears, crying more than usual, trouble sleeping, acting fussy/irritable.
• Loss of appetite: This may be most noticeable in young children, especially during bottle feedings. Pressure in the middle ear changes as the child swallows, causing more pain and less desire to eat.
• Irritability: Any kind of continuing pain may cause irritability.
• Poor sleep: Pain may be worse when the child is lying down because the pressure in the ear may worsen.
• Fever: Ear infections can cause temperatures from 100° F up to 104° F. Some 50% of children will have a fever with their ear infection.
• Drainage from the ear: Yellow, brown, or white fluid that is not earwax may seep from the ear. This may mean that the eardrum has ruptured .
• Trouble hearing: Bones of the middle ear connect to the nerves that send electrical signals to the brain. Fluid behind the eardrums slows down movement of these electrical signals through the inner ear bones.

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Differences Between Middle Ear Infection And Outer Ear Infection

Antibiotics And Other Prescriptions

Centers for Disease Control and Prevention , using antibiotics by mouth to treat ear infections may not help certain cases of middle ear infections. Antibiotics are not effective against outer ear and viral infections.

The main treatments for outer ear infections are manual cleanings and ear drops. The type of ear drop will depend on what is causing the infection. In the case of malignant otitis externa, intravenous antibiotics are the primary treatment.

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What Do You Suggest For People Who Feel Like There Might Be Moisture In Their Ears

Dr. Wang: You can usually feel it if there’s some water in your ear, right? If you notice that, turn your head to the side and try to shake the water out or let it drain out. You can also place a tissue paper or thin dry cloth around your finger and wipe outside the opening of your ear with your head turned sideways. If you still feel it, or have a history of getting a lot of outer ear infections, use drops to dry out your ears. You can buy Swim-EAR® or other brands over the counter, or you can look up how to make your own by mixing together rubbing alcohol and vinegar. A cool or warm hair dryer may also be effective.

What Should I Expect If I Or My Child Has An Ear Infection

Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.

Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.

If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.

Never hesitate to contact your healthcare provider if you have any concerns or questions.

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Where Is The Middle Ear

The middle ear is behind the eardrum and is also home to the delicate bones that aid in hearing. These bones are the hammer , anvil and stirrup . To provide the bigger picture, lets look at the whole structure and function of the ear:

The ear structure and function

There are three main parts of the ear: outer, middle and inner.

• The outer ear is the outside external ear flap and the ear canal .
• The middle ear is the air-filled space between the eardrum and the inner ear. The middle ear houses the delicate bones that transmit sound vibrations from the eardrum to the inner ear. This is where ear infections occur.
• The inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.

Other nearby parts

• The eustachian tube regulates air pressure within the middle ear, connecting it to the upper part of the throat.
• Adenoids are small pads of tissue above the throat and behind the nose and near the eustachian tubes. Adenoids help fight infection caused by bacteria that enters through the mouth.

Will I Need Any Tests For A Fungal Ear Infection

Your doctor will probably treat your ear first and take an ear swab if the condition doesn’t get better. Taking an ear swab is a fairly simple procedure and involves the doctor putting a swab that looks very similar to a cotton bud in your ear and swishing it around. This shouldn’t be painful unless your ear is very tender and inflamed from the infection. Even then, gentle swabbing should only cause mild discomfort.

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Symptoms Of Ear Infections

Intense pain in your childs ear is usually the first sign of an ear infection. Young children can tell you that their ear hurts, but babies may only cry. Your child may repeatedly pull on the ear that hurts. The pain is usually worse at night and when your child is chewing, sucking a bottle, or lying down. Thats when the pressure is at its greatest. Other symptoms include a runny nose, cough, fever, vomiting, or dizziness, and hearing loss.

When Should I Take My Child With An Ear Infection Back To The Doctor

Once an ear infection is diagnosed, your child should start to improve within 24 to 48 hours. Go back to your doctor if:

• an earache is not settling after 2 days
• fluid starts coming out of your child’s ear
• your child seems more unwell

There are some very rare complications of ear infections. You need to go back to a doctor immediately if your child:

• has any swelling, redness or tenderness in or around the ear
• is feeding poorly
• is floppy, sleepy or drowsy
• is becoming less responsive
• is not interested in surroundings
• complains of a stiff neck or light hurting their eyes

Always take your child to your family doctor for an ear check 4 to 6 weeks after any ear infection, to make sure the ear fluid has gone.

Always take your child to your family doctor for an ear check after any ear infection, to make sure the ear fluid has gone. Go to your doctor again 4 to 6 weeks after the ear infection.

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How Is A Fungal Ear Infection Treated

If the inside of your ear looks really messy, the doctor may suggest a clean-up. This has the odd name of aural toilet. It can be done by a doctor or more usually a nurse. It involves gently clearing the ear of discharge using swabs, a suction tube or syringe. This may need to be done several times a week in the first instance. Aural toileting eases discomfort and also helps ear drops to get to the right place. However, it may be a bit uncomfortable while you’re having it done, and you may need to take some painkillers.

Don’t fiddle with your ear, keep it dry and try to resist scratching inside, however itchy it may be, as this will stop the infection from clearing up. It’s not usually advisable to put a cotton wool plug in the ear unless you get a lot of discharge and you need to keep it under control for the sake of appearances.

Avoid swimming until the condition clears up.

Your doctor may prescribe 5% aluminium acetate ear drops. This is also known as Burow’s solution. It’s not an antifungal but is used to calm down inflammation and help remove any muck in your ear.