Ear Infection

Reviewed by Charge Audiologist
Ron Trounson

Table of Contents

What Causes an Ear Infection?

Several things can cause an ear infection. One of the most common is a blockage in the Eustachian tube, which drains fluid from the middle ear. When this happens, bacteria can grow in the fluid and cause an infection.

Viruses, fungi, allergies, or even exposure to secondhand smoke may also cause an ear infection.

In children, ear infections are often the result of a cold or flu. Children are more susceptible to ear infections because their Eustachian tubes are shorter and more horizontal than those of adults. 

Some of the contributing conditions and scenarios for ear infection include:

  • Upper respiratory tract infections (a cold, for example).
  • Trauma or injury to the ear.
  • Eustachian tube dysfunction.
  • Swimming in polluted waters.
  • Not drying the outer ear properly after getting wet.
  • Excessive cleaning of the ears with cotton buds or other foreign objects.
Ear Health nurse practitioner looking through a microscope to inspect a patient for an ear infection

10 Signs of an Ear Infection

The symptoms of an ear infection depend on the type of infection and where it occurs in the ear.

  1. Earache.
  2. Mild deafness.
  3. Ear discharge.
  4. Fever.
  5. Headache.
  6. Loss of appetite.
  7. Ears are itchy.
  8. Blisters inside or outside of the ear.
  9. Hearing ringing, buzzing or humming (tinnitus)
  10. Vertigo or loss of balance.

The 7 Types of Ear Infection

Ear infections can be grouped in the part of the ear in which they occur.

  1. Outer ear infections.
  2. Middle ear infections.
  3. Inner ear infections.
Each part or section of the ear has different types of ear infections.
The diagram below illustrates how the ear is divided into three parts; the outer ear, middle ear and inner ear.
Illustrated anatomy diagram of the human ear
Human ear diagram showing the outer, middle and inner ear sections.

a) Outer Ear Infections

Outer ear infections occur in the outer ear canal, also called the external auditory canal.

1. Otitis Externa

Otitis externa is an inflammation of the external ear canal. It is also known as swimmer’s ear. The condition is caused by a bacterial or fungal infection.

2. Otomycosis

Otomycosis is a fungal ear infection that commonly affects the outer ear canal. The infection is caused by a variety of fungi, including Aspergillus, Candida, and Fusarium species.

b) Middle Ear Infections

Middle ear infections are the most common type of ear infection and occur when fluids build up in the middle ear.

3. Acute Otitis Media

Acute otitis media (AOM) is a condition that results when the middle ear becomes infected. AOM is the most common type of ear infection, particularly in young children.

4. Otitis Media With Effusion

Otitis media with effusion (OME) is a condition characterized by the accumulation of fluid in the middle ear without the presence of signs or symptoms of infection. This fluid can build up over time, eventually leading to hearing loss.

5. Chronic Otitis Media With Effusion

Chronic otitis media with effusion (COME) is a long-term condition characterized by fluid accumulation in the middle ear. This fluid can cause hearing loss and other problems. Otitis media with effusion (OME) is a similar condition, but it is not considered chronic unless it lasts more than three months.

c) Inner Ear Infections

Inner ear infections occur when an infection spreads to the inner ear. Internal ear infections can be severe because they can cause balance problems and hearing loss.

6. Vestibular Neuritis

Vestibular neuritis is a condition that results from inflammation of the vestibular nerve. This nerve transmits balance and head movement information from the inner ear to the brain. When the vestibular nerve is inflamed, it can no longer function properly, leading to symptoms such as vertigo, nausea, and vomiting.

7. Labyrinthitis

Labyrinthitis is an infection that affects the labyrinth, the balancing centre in the inner ear. The labyrinth is a complex system of canals filled with fluid that helps regulate both hearing and balance.

1. Otitis Externa

Otitis externa (swimmer's ear) human anatomy diagram.
Otitis externa (swimmer's ear) human anatomy diagram.

Otitis externa, also called swimmers ear, is an outer ear infection. It’s often the result of water getting trapped in your ear, followed by the growth of bacteria or fungal organisms. It commonly occurs during the summer when people swim more frequently, and their ears stay warm and moist.

Possible causes of otitis externa may include:

  • swimming in water that contains bacteria
  • scratching the inside of your ear
  • getting something stuck in your ear.

Otitis externa is also more common in tropical environments, where keeping your outer ear dry is often more challenging.

The usual signs of otitis externa are itchiness in the ear, hearing loss, ear pain, and having yellow or yellow-green, smelly pus drain from the ear.

This type of ear infection is typically treated with antibiotic ear drops. The ears should also be kept dry during the treatment of this ear infection.

Ear cleaning by microsuction may help clear the ear canal, making it easier to administer ear drops, soothe the irritation and relieve the blocked feeling.

2. Otomycosis

Two ears showing symptoms of otomycosis
Ears showing symptoms of otomycosis.
Mohammad2018, CC BY-SA 4.0, via Wikimedia Commons

Otomycosis is a fungal infection of the outer ear. Most infections are caused by Aspergillus species or, less commonly, Candida. Typically this type of infection will cause dry skin, inflammation, and a smelly discharge in the ear canal.

Fungi are present in our daily environments and usually pose no threat. However, people who live in warmer tropical and subtropical climates where fungi thrive are more at risk. And people with a weakened immune system are more susceptible to fungal infection.

The risk factors for otomycosis are pretty similar to those of otitis externa. Certain activities and injuries can make you more prone to otomycosis, such as:

  • swimming or surfing, especially in contaminated water
  • an injury or scratch in your ear canal
    excessive cleaning
  • a lack of ear wax protecting your ears
  • eczema and other skin conditions.

Otomycosis is usually easily treated with topical antifungal drops and creams. Oral medications are used for more severe infections or species of fungi resistant to topical medications.

3. Acute Otitis Media

Human anatomy diagram of otitis media
Human anatomy diagram of otitis media.

Otitis media is a nonexclusive term used to describe many middle ear infections. Otitis media is often preceded by a respiratory illness such as a cold, flu or allergy with swelling and fluid accumulation in the middle ear.

Acute otitis media (AOM) is a bacterial or viral infection of the middle ear that progresses rapidly. It is a common problem in early childhood. The middle ear will show signs and symptoms of acute inflammation and effusion, usually within 48 hours after symptoms begin.

The symptoms of otitis media are earache, discharge from the ear, ear-popping, ear fullness, hearing loss, fever and dizziness.

A baby or young child with AOM may tug on the ear, cry or fuss more than usual, lose their appetite, and have trouble sleeping.

Visible with a microscope, a bulging tympanic membrane is typical in the case of AOM.

Eustachian tube dysfunction that traps fluid and pus in the middle ear is common in most types of otitis media.

Otitis media is the leading condition for antibiotic prescribing and surgery in young children.

Acute otitis media will usually have symptoms related to:

  • fever and pain
  • difficulty hearing
  • ear discharge.

4. Otitis Media With Effusion

Otitis media with effusion (OME), also called glue ear, is characterised by fluid in the middle ear without signs or symptoms of inflammation.

OME can occur just before or persist after infection for a few days or up to many weeks. Children are more likely to experience OME due to the small size and shape of their Eustachian tube relative to adults.

75% of children have at least one OME episode by school age. Most often, between the ages of 6 months to 4 years.

OME isn’t an ear infection, but they can be related. For example, an ear infection can affect how well fluid flows through the middle ear.

The main symptom of OME is feeling fullness or pressure in the ear, although some people may also experience muffled hearing or pain. In most cases, OME will resolve itself without treatment within three months. However, medical intervention may be necessary if the condition persists for longer.

5. Chronic Otitis Media With Effusion

Chronic Otitis Media with Effusion (COME) is a condition that affects the middle ear. As a chronic condition, COME persists for more than three months.

Like OME, COME is characterised by the buildup of fluid in the middle ear without an infection, which can cause hearing problems and other symptoms.

The exact cause of COME is unknown, but it is thought to be related to allergies, immune disorders, or structural abnormalities of the ear.

Treatment for COME may involve: 

  • Medication to reduce the amount of fluid in the middle ear.
  • Surgery to repair damaged tissue or insert tubes into the middle ear, called grommets.

Grommets allow air to pass through the eardrum and equalise the air pressure on either side.

6. Vestibular Neuritis

Human ear anatomy diagram of vestibular neuritis showing inflamed cochlear and vestibular nerves.
Human anatomy diagram of vestibular neuritis.

Vestibular neuritis is a condition that affects the vestibular nerve, which controls balance and eye movement.

The vestibular nerve helps the brain to interpret information from the inner ear about movement and position. In vestibular neuritis, the vestibular nerve becomes inflamed, which can cause dizziness, vertigo, and nausea.

The exact cause of the inflammation is unknown, but it is thought to be caused by a viral infection.

Vestibular neuritis typically resolves independently within a few weeks, but some people may experience lingering symptoms.

Treatment for vestibular neuritis focuses on managing symptoms and preventing complications.

7. Labyrinthitis

Human ear anatomy diagram of labyrinthitis showing inflammation of the inner ear.
Human ear anatomy diagram of labyrinthitis.

Labyrinthitis is an inner ear condition that results when the labyrinth, a fluid-filled structure in the inner ear that helps with balance and hearing, becomes inflamed. This inflammation can be caused by a viral infection, such as the flu, meningitis, or bacteria.

The symptoms of labyrinthitis include vertigo (a feeling of spinning), nausea, vomiting, loss of balance, and hearing loss. In some cases, these symptoms can last for several weeks.

Treatment typically involves rest and over-the-counter medications to help relieve symptoms. In severe cases, however, hospitalization may be necessary. In most cases, labyrinthitis resolves on its own over time.

Jerika Pring

Jerika Pring

I received my Bachelor of Science in Nursing in 2009 and have 10 years of nursing experience effectively and efficiently managing both patients and staff. I've had experience in Medical and Surgical Wards, Otolaryngology, Gynecology and Obstetrics, Neurology, Pediatrics, Aged Care, and worked as a certified laser technician.

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