Ear infection (middle ear)

An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.

Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Ear infection in infants and severe cases in general often require antibiotic medications. Long-term problems related to ear infections — persistent fluids in the middle ear, persistent infections or frequent infections — can cause hearing problems and other serious complications.

Symptoms Causes Risk factors Complications Prevention

The onset of signs and symptoms of ear infection is usually rapid.


Signs and symptoms common in children include:

  • Ear pain, especially when lying down
  • Tugging or pulling at an ear
  • Difficulty sleeping
  • Crying more than usual
  • Acting more irritable than usual
  • Difficulty hearing or responding to sounds
  • Loss of balance
  • Fever of 100 F (38 C) or higher
  • Drainage of fluid from the ear
  • Headache
  • Loss of appetite


Common signs and symptoms in adults include:

  • Ear pain
  • Drainage of fluid from the ear
  • Diminished hearing

When to see a doctor

Signs and symptoms of an ear infection can indicate a number of conditions. It's important to get an accurate diagnosis and prompt treatment. Call your child's doctor if:

  • Symptoms last for more than a day
  • Ear pain is severe
  • Your infant or toddler is sleepless or irritable after a cold or other upper respiratory infection
  • You observe a discharge of fluid, pus or bloody discharge from the ear

An adult with ear pain or discharge should see a doctor as soon as possible.

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