7 Middle Ear Infection Symptoms

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Middle ear infection is the most common ear infection, affecting at least 11% of the global population per year. This means that up to 710 million people suffer from middle ear infections every year. Other studies show that the figure is significantly lower at about 65-330 million, translating to 1% to 5% of the global population.


About half of the cases involve children under five years, especially males. About 10% of children are affected before the age of 10. Meanwhile, only about 0.25% of adults are affected per year.

The good news is that most middle ear infections are easily treatable. Only about 4.8% of reported cases develop into chronic issues. Unfortunately, left untreated, a middle ear infection can kill. At least 3,200 deaths were reported in 2015.

You can take a few steps to prevent the condition. However, it’s just as important to know the symptoms so you can address the problem immediately in case it occurs.

What is Middle Ear Infection?

Also known as otitis media, middle ear infection is an infection of the middle ear, i.e., the air-filled space behind the eardrum (tympanic membrane).

The word “otitis” actually means inflammation of the ear. There are three categories of otitis, i.e., otitis externa (inflammation of the outer ear), otitis media (inflammation of the middle ear), and otitis interna (inflammation of the inner ear).

Some people often confuse otitis media with swimmer’s ear – caused by water trapped in the ear. However, swimmer’s ear is an outer ear infection, i.e., otitis externa.

What Causes Otitis Media?

Nearly all ear infections are caused by either virus or bacteria. Many times, the infections begin after a cold or other infection. The virus or bacteria from the unrelated infection may travel to the middle ear through the Eustachian tube that connects the middle ear to the throat.

Alternatively, the virus or bacteria may cause the Eustachian tube to swell, potentially resulting in blockage. A blockage may impede the normal flow of fluids inside the ear, resulting in a buildup in the middle ear.

The main reason children are the most affected is that the Eustachian tube is shorter and has a flatter slope in kids. It makes it easier for children’s ears to be clogged. It also makes it more difficult to drain the clogged ear, which increases the risk of infection.

Symptoms of a Middle Ear Infection

Symptoms in children and adults tend to differ slightly. However, there are seven main symptoms every otitis media patient exhibits;

  1. Pain in the ear: This symptom is present in both children and adults. Children too young to speak may cry more than usual. They may also act fussy. Older kids, meanwhile, may complain about the nagging pain in the affected ear.
  2. Loss of appetite: Though more common in toddlers, older children with otitis media may also lose appetite. Even adults may experience difficulty eating. The main reason is that otitis media pain tends to worsen when swallowing because of the Eustachian tube that links to the throat.
  3. Irritability: People with middle ear infections are typically irritable because of the mild pain (which can be worse as the condition progresses) and the feeling of fullness in the ear. The degree of irritability is more significant in children.
  4. Trouble sleeping: This symptom is also more pronounced in children though adults may also experience difficulty sleeping. The reason is that pressure in the ear worsens when you’re sleeping.
  5. Fever: People with a middle ear infection can have a high fever. In many cases, temperatures shoot to about 104˚F, i.e., four degrees higher than usual. However, some people may not exhibit this symptom. For example, only about 50% of children with otitis media report fever.
  6. Trouble hearing: The middle ear contains delicate bones that aid in hearing. These bones connect to nerves that send electrical signals (as sound) to the brain. When you have a middle ear infection, the fluid that forms behind the eardrum can slow down the movement of the electrical signals resulting in compromised heating.
  7. Drainage from the ear: In extreme cases, a middle ear infection can cause the eardrum to rupture. You’ll know that the patient’s eardrum has raptured if you notice yellow, brown, or white fluid that’s not wax draining from the affected ear. The good news is that eardrums heal naturally after about two months.

When to See a Doctor

Although middle ear infections often clear up on their own, you don’t want to wait too long as the issue can turn into a chronic infection.

We recommend seeing a doctor if the symptoms last more than two days, the pain is severe, or you observe a discharge of pus or bloody fluid. Also, all cases involving babies under six months should be reported to the doctor.

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