Middle ear infections are most common in children under age 5. Crankiness, a fever, and tugging at or rubbing the ear may all be signs that your child has a middle ear infection, particularly if your child has a cold or viral illness. It's important to call your health care provider if you notice these or any of the signs listed below.
Call your health care provider's office if you notice any signs of a middle ear infection.
Middle ear infections occur behind the eardrum. The eardrum is the thin sheet of tissue that passes sound waves between the outer and middle ear. These infections are usually caused by bacteria or viruses, which are often related to a recent cold or allergy problem.
In young children, these bacteria or viruses likely reach the middle ear by traveling the short length of the eustachian tube from the back of the nose. Once in the middle ear, they multiply and spread. This irritates delicate tissues lining the middle ear and eustachian tube. If the tube lining swells enough to block off the tube, air pressure drops in the middle ear. This pulls the eardrum inward, making it stiffer and less able to transmit sound.
Once the eustachian tube swells shut, moisture can’t drain from the middle ear. Fluid that should flush out the infection builds up in the chamber. This may raise pressure behind the eardrum. This can decrease pain slightly. But if the infection spreads to this fluid, pressure behind the eardrum goes way up. The eardrum is forced outward. It becomes painful, and may break.
If the eardrum doesn’t break and the tube remains blocked, the fluid becomes an ongoing condition (chronic). As the immediate (acute) infection passes, the middle ear fluid thickens. It becomes sticky and takes up less space. Pressure drops in the middle ear once more. Inward suction stiffens the eardrum. This affects hearing. If the fluid is not removed, the eardrum may be stretched and damaged.
A temperature over 100.4°F (38.0°C) and cold symptoms
Severe ear pain
Any kind of discharge from the ear
Ear pain that gets worse or doesn’t go away after a few days
Call your health care provider's office if your otherwise healthy child has any of the signs or symptoms described below:
In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher
In a child of any age who has a repeated temperature of 104°F (40°C) or higher
A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older
Your child has had a seizure caused by the fever
Rapid breathing or shortness of breath
A stiff neck or headache
Persistent brown, green, or bloody mucus
Signs of dehydration, which include severe thirst, dark yellow urine, infrequent urination, dull or sunken eyes, dry skin, and dry or cracked lips
Your child still doesn't look right to you, even after taking a non-aspirin pain reliever