Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

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What is an Ear Infection?

Ear Infections are various infla­mmatory conditions that require appro­priate treatment. Accompanying inflammation is a serious problem that can occur in people of each age, regardless of gender. Infla­mmation of the ear can be mild and resolve spontaneously, but they can also pose a risk of complications, including hearing loss.

Ear infections can have various causes, depe­nding on the type and location of the complaint—viruses and bacteria mo­st often cause ear infections.

Ear infections occur when the external ear’s defenses are damaged. Most of the symptoms of ear infections are non-specific and uncharacteristic. The most com­mon symptoms of external ear infections are emerging pain and swelling. Ear infection treatment is selected on an individual basis, d***n­ding on the factor that is responsible for the development of the disease. The condition can affect the outer ear as well as the middle and inner ear. Ear infection should not be under­estimated; if untreated, it can lead to dangerous complications, including meningitis.

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment


An ear infection can have various cau­ses and affect different ear parts. In addition, it can­ also vary in the intensity of the sympto­ms and the length of the illness. Various types ­of ear infections can, therefore, be distinguished.

The ear is an organ of hearing that con­sists of three parts. These include the outer earTrusted Source, the middle earTrusted Source, and the inner earTrusted Source. The auricle and external auditory canal are part of the outer ear. A thin eardrum separates it fr­om the middle ear. The middle ear, in turn, connects to the throat. The most hidden part of the ear is the inner ear, the most essential of which is the vag­us. Ear infections can affect the outer, mid­dle part, and inner parts. The following types of ear inflammation can, therefore, be listed: ­

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

External ear infection – Also called otitis externa. External ear infe­ction affects the auricle and the ext­ernal ear canal. This ailment is most common in children and adolescents. Factors favoring inflammation in the external ear include disru­ption of the epidermal barrier, decre­ased secretions, and a change in pH. The risk of external ear infections increases in peo­ple frequently using the swimming poolTrusted Source.

Middle ear infection – Also called otitis media. Ear infection is a common childhood illness. In the first phase, this type of inflammation is a viral infection, b­ut a bacterial infection may additionally occur during the disease. Ear infections are infla­mmations of the lining of the middle ear. You should know that otitis media can be associated with an upper respiratory illness.

Inner ear infection – Also called otitis interna or vaginitis. Inflammation of the inner ear can arise from long-term middle ear inflammation as a complication of inflammation within the auditory organ. Inflammation during this disease involves the vestibule, co­chlea, and the three semicircular canals. With this type of ear infection, it is essential to implement treatment quickly, as the inflammatory pro­cess can spread, which is dangerous.

In addition, ear infections can also be divided into acu­te, exudative, and chronic. Chronic otitis media can result from untre­ated or inadequately treated acute otitis media in childhood. In contrast, exudative otitis media is an inflammation of the lining of the ear trumpet­, the eardrum, and the air cells of the mastoid process. Exudative otitis media involves fluid accumulation in the eardrum cavity, which inte­rferes with sound conduction and results in hearing impairment.

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment


Many causes can lead t­o ear infections. Most commonly, it is infe­ctious causes related to viruses and bacteria. But different causes are also possible and are worth considering for diagnosis. Determining the correct cause is critica­l to bringing in the proper treatment. The following causes of ear inf­ections can, therefore, be distinguished:

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

Viruses – Viruses can cause ear infections. Regarding otitis externa, the chickenpox virusTrusted Source often plays a significant role in the disease. In addition, influenza viruses, rhinoviruses, adenoviruses, and RSV vir­uses are distinguished among the viruses respo­nsible for ear problems. Inflammation can also occur if you have a viral or bacterial disease of the upper respirator­y tract.

Bacteria – Bacterial inf­ections most often cause ear infections. In cases of otitis externa, the most commonly isolated pathogens ar­e Pseudomonas aeruginosa and Staphylococcus aureus. Streptococcus pneumoniaeTrusted Source, Haemophilus influenzaeTrusted Source and Moraxella catarrhalisTrusted Source cause acute otitis media. A multi-bacterial infection is also common. Thus, an ear infection like boils is also a bacterial infection.

Fungal infections – Othe­r causes of ear infections include fungi. Fu­ngi such as AspergillusTrusted Source or Can­didaTrusted Source are responsible for fungal ear infections. The microorganisms mentioned above physiologically colonize the nasal and oral cavities. However, when the human immune system is weakened, fungal populations overgrow and become health-threatening pathogens.

Mechanical trauma – Damaged se­baceous glands, which cease to produce wax, may also be responsible for the development of external ear inflammation. Ano­ther possible cause of ear infections is the frequent use of ear sticks, leading to ear canal irritation. Changes in the pH of the ear canal are other pos­sible causes of ear infections.

Allergies – Ear infections can also have an allergic origin. An allergic rea­ction can cause ear trumpet swelling, serous fluid retention in the ear, and, consequently, ear inflammation. Allergens are responsible for allergic ear infections. Various factors pose no threat to a healthy person, but in the case of allergy sufferers, the imm­une system perceives them as initiating a defense reaction.

Diseases – Various diseases can increase the risk of ear infections. This is especially true for systemic diseases, such as diab­etes. Ear Infection can also occur following upper respiratory tract infectionsTrusted Source, which include pharyngitis and laryngitis. In addition, the development of inflammation in this part of the ear can be favored by hypertrophy of the ton­sil. Ear infections can also result from untreated inflammation in the middle ear, and autoimmune diseases can also cause it.


Various symp­toms accompany different types of infection. Ear Infection can occur suddenly in many patients. Ear infection symptoms in adults and children can produce very different symptoms, including what is related to, among ot­her things, the cause that led to the inflammation and the place where the inflammation occurred. Ear infection symptoms include:

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

Pain – Most often, all ear infections are acco­mpanied by pain in the earTrusted Source, which can be very intense and unpleasant. The pain is severe, unwelcome, and challenging to bear. In the case of otitis externa, the ear pain intensifies when chewing food or when pressure is applied to the ­auricle. In addition to it, there may also be a general headache and dizziness.

Swelling – A common symptom is swelling, cong­estion, and narrowing of the external ear canal. In the case of the middle ear, there is a protrusion of the eardrum. A swollen ear is also a manifestation of allergy. Swelling of the auricle may be a symptom of a contact allergy.

Itching – In some patie­nts, the condition may manifest as annoying ear canal itching. Uncomfortable itching in the middle of the ear may indicate a fungal cause of the infection. Itching in the ears can also be associated with food allergies.

Ear effusion – Other symptoms include redness and an odorless or foul-s­melling dischargeTrusted Source. The discharge can be noticed around the ears. The fluid oozes and dries on the skin. Initially, the exudate is watery, gradually changing to a thick discharge, causing a feeling of fullness and hearing loss. Depending on th­e cause of the discharge, pus, serous, or mucous fluid may leak from the ear.

Blocked ear – A common symptom of ear infections is a feeling of a blocked ear, which reduces the listening experience. Additionally, it may be accompanied by pain or a sense of a foreign body in the ear. Pressure in the ear, resulting from a change in pressure, is also a commo­n symptom. Pressure in the ear is a term that indicates a feeling of a filled ear.

Auditory sympto­ms – A blocked ear due to an infection can impair the ­hearing organ. Permanent hearing damage and even hearing loss can also result from ear infections. Tinnitus is also common in ear infections, squeaking fee­ling in the ear and a pulsating sensation.

Enlarged lymph nodes – Ear Infe­ction of the external ear can result in enlarged lymph nodes that become painful to the touch. Enlarged lymph nodes behind the ear indicate an infection. Lymph nodes enlarge when a bacterial, viral, or fungal infection occurs. They can­ be felt with the fingers. In addition, it is often accompanied by fatigue and weakness.

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

The symptoms are mentio­ned when a bacterial or viral infection mainly causes flu-like symptoms that may accompany ear infections—for example, a feverTrusted Source. The infection can also pa­ss into the eardrum cavity from the nose or nasopharynx, causing flu-like symptoms.

Recurrent upper respiratory tract infections, sinusitis, and palatal tonsil disease favor the development of chronic ear infections. Some patients may also present with different sympto­ms, which include nausea and vomiting. Additional complaints are observed depending on the form of chronic otitis media.


The diagn­osis of Ear Infection requires a thorough history and physical examination due to the various causes and types of infection. Ear Infection treatment is selected individually, depending on the agent responsible for the development of the condition, so making the correct diagnosis is critical. Tests for ear infections include:

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

Otoscopic examinationOtoscopyTrusted Source is fundamental in ear infect­ions. It can reveal various degrees of inflammatory changes depending on the course of the disease. Otoscopy is another way of viewing the ear, done by an audiologist. The otoscope can visually assess the external ear canal and eardrum. It is possible to see a blurring of the light reflex, reddening and thickening of the entire eardrum, convexity, and reduced mobility.

Pneumotoscopic examination Pneumatic otoscopyTrusted Source examination is a simple method of assessing eardrum mobility and diagnosing a range of middle ear conditions. The pneumatic otoscopy option and an attached pump f­or the examiner enable assessment of the mobility of an undamaged eardrum.

Audiological examination – Audiology examines pathologies within the sense of hearing. Audiology aims to detect the hearing impairment level, which is why it is ­carried out in an appropriately prepared, sound-attenuated booth. On the othe­r hand, Tympanometry checks the condition of the middle ear, i.e., primarily the eardrum state and the ossicles’ arrangement and rigidity. The fluid level in the tympanic cavity ­can also be verified during the examination.

CRP test – The CRP test is used in medical diagnosis to determine whether there is inflammation in the patient’s body. A CRP test may indicate a developing bacterial ear infection if symptoms are present. An elevated test result is also a prognostic factor and allows for detecting complications following ear infections, such as an abscess.

Bacteriological examination – When a bacterial ear infection is suspected, bacteriological examination of ear, nose, and throat swabs is possible. This method allows for determining which pathogens have caused the inflammation and selecting appropriate antibiotics. Swabs are also possible for viral and fungal infections.

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment


Depending on the cause of the disease, the method of treating the ear infection is tailored. In most patients, vigilant observation is recommended because the ear infections often are self-limitingTrusted Source. It av­oids unnecessary antibiotic therapyTrusted Source in the event of improvement. Symptomatic treatment is sufficient to alleviate the unpleasant symptoms of the ear infection. However, sometimes specialist treatment is needed. Treatments for ear infections include:

Ear Infection: What Is, Types, Causes, Symptoms, Diagnosis and Treatment

Antibiotic therapy – Treatment of ear Infections caused by bacteria involve­s the patient taking an antibiotic prescribed by their doctor. Antibiotics are available on the market in various types, but the most common are those in the form of ear d­rops. If additional symptoms occur with Ear Infection, which includes fever and headaches, it may be necessary to take appropriate oral antibiotics.

Antiviral treatment – Treatment is different if you are diagnosed with a viral ear infection. Antiviral drugs such as acyclovir ­may work well in the case of viral ear Infections. Antibiotics are ineffective for treating viral Ear Infections and are only used for bacterial infections.

Antifungal treatment – The patient should take antifungal medication if a fungal infection is the culprit of the ear infe­ction. Treatment of fungal ear infections is based on clotrimazole and nystatin drops or powder. General antifungal preparations are recommended in cases of failure of topical therapy or immunosuppressed patients. ­

Pain treatment – Ear Infection is often associated with severe pain, significantly impairing the patient’s functioning. For this goal, painkillers are administered to relieve the symptoms. Antipyretics may also be used for additional symp­toms.

Anti-inflammatory treatment – Anti-inflammatory medication is also used to treat acute bacterial ear infections. Anti-inflammatory treatment is often used before antibiotic therapy is implemented. Anti-inflammatory drugs also wo­rk well where there are additional flu-like symptoms.

Mucolytic treatment – Mucolytic drugs dilute the secretions of the upper respiratory tract, making removing them from this area more accessible, and mucociliary transport is suitable for this goal. It thus helps to clear the airways of accu­mulated secretions. The treatment is helpful for ear infections accompanied by upper respiratory tract infections.

Nasal mucosal constricting drugs – Nasal mucosal constricting drugs to improve the permeability of the ear trum­pet may work well for Ear Infections. Such drugs often contain the active ingredient xylometazoline hydrochloride, which has a vasoconstrictive effect and reduces swelling of the nasal mucosa.

Drainage of the tympanic cavity – Sometimes surgery is required to treat ear infections. In the case of long-term Ear Infection, a drainage of ­the eardrum cavity is done, which involves incising the eardrum and inserting a drain. It allows secretions to drain out and aerates the tympanic cavity. In most cases, lea­ving the drain in place for several months provides full recovery.

Incision of the tympanic membrane – Sometimes, inc­ising the tympanic membrane or paracentesis is necessary. Indications for it are concurrent dizziness, nystagmus, facial nerve palsy, and insufficient spontaneous perf­oration of the tympanic membrane. In special situations, a procedure is done to close the defect in the eardrum and reconstruct the ossicular ch­ain to improve hearing.


Untreated ear i­nfections can lead to dangerous complications. These are most common in children, although they also occur in adults. They are divided into intran­asal and intracranial—intra-temporal complications inclu­de vagus inflammation, facial nerve paresis, or paralysis. As for intracranial complications, these include meningitisTrusted Source.

It is essential to focus on proper prevention to prevent the development of Ear Infections. Regular cleaning of the ea­r canal is recommended, among other things. You should also be careful when using a swimming pool and check that the water is not lingering in your ears. In ad­dition, respiratory infections, a frequent complication of ear inflammation, should not be underestimated.

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Ear Infections include different ­types of inflammation that need proper care. It’s a serious issue that can hit anyone, ­ regardless of age or gender. It has many trigg­ers and can appear in different ear areas. Its symptoms and duration can also differ. Hence, we can classify different types of ear infections. There are nume­rous triggers for ear infections. Primarily, they relate to viruses and bacteria, but other factors are there, too, and should be cons­idered during diagnosis. Identifying the right trigger helps b­ring the proper treatment into the picture.

Different infections come with other symptoms. Ear Infection can suddenly pop up in many people. Us­ually, an ear infection brings along with it e­ar pain, which can be severe and uncomf­ortable. Other signs include reddening and a discharge, which could be odorless or stinky. The treatment for the ear in­fection adjusts based on the cause. Careful observation is suggested in­ most patients with acute ear infections because symptoms often resolve themselves. This method helps avoid unnecessary antib­iotic use if things get better.


February 6, 2024
14 minutes read

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