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By Dr Dulcy Rakumakoe

Chief Executive Officer

Ear Infection: Signs, symptoms and treatment

Ear infections, caused by bacteria or viruses, can lead to hearing problems and other complications if left untreated.

An ear infection is an infection of the middle ear. It is more common for children, rather than adults, to get ear infections. The Eustachian tube is a narrow tube that runs from the middle ear to the back of the throat.

In an ear infection, this tube can become swollen and blocked. This can lead to mucus build-up in the middle ear, which can become infected and cause ear infection symptoms.

Ear infections are usually self-healing and don’t need treatment, but managing the pain and monitoring the problem is very helpful.

Importance of medical examination for accurate diagnosis

Sometimes, antibiotics are used to clear the infection. If you have multiple ear infections, you can develop hearing problems and other serious complications. An ear infection is caused by a bacteria or virus, usually following a cold, flu or an allergy.

Signs and symptoms of an ear infection can indicate several conditions. So it is important for you to be examined by your doctor to make an accurate diagnosis.

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Picture: iStock


Signs and symptoms of ear infection usually develop very quickly. In children, the common ones include:

  • Ear pain, especially when sleeping or lying down.
  •  Irritability and crying.
  • Trouble hearing or responding to sounds.
  •  Loss of balance.
  •  A fever of 38ºC or even higher.
  •  Fluid or pus coming out of the ear.
  • Headache.
  • Loss of appetite.

    In adults, the common signs and symptoms include:
  •  Ear pain
  •  Fluid or pus coming out of the ear.
  • Swelling of the cheek around the ear.
  •  Trouble hearing.
Picture: iStock
Picture: iStock

Risk Factors

Risk factors for ear infections include:

  • Age. Children between the ages of six months and two years are more susceptible to ear infections.
  • Children who congregate in crowded places like a crèche or school.
  • Bottle-feeding babies while they are lying down.
  • Children who are born with a cleft palate.


Recurrent ear infections are the ones that lead to complications such as:

  • Loss of hearing.
  •  Loss of hearing will lead to a delay in speech, social and developmental skills.
  •  Spread of infection to nearby tissues in the skull including the brain or the membranes surrounding the brain (meningitis).
  • Tearing of the eardrum. Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.
Picture: iStock
Picture: iStock


These tips may reduce the risk of developing ear infections:

  • Prevent common colds and other illnesses by teaching children to wash their hands frequently and thoroughly.
  • Do not share eating and drinking utensils.
  • Cough or sneeze into your elbow.
  • If possible, keep your child home from crèche or school if they’re ill.
  • Make sure that no one smokes in your home.
  •  Breastfeed your baby. If possible, breastfeed your baby for at least six months. Breast milk contains antibodies that may offer protection from ear infections.
  •  If you bottle-feed, hold your baby in an upright position.
  • Talk to your doctor about vaccinations. Flu, pneumonia and all other vaccinations according to the schedule.
Picture: iStock
Picture: iStock


Symptoms of ear infections usually improve in the first few days, and most infections clear up on their own within one to two weeks without any treatment.

Some ear infections resolve without antibiotic treatment. Some evidence suggests that treatment with antibiotics might be helpful for certain children with ear infections.

On the other hand, using antibiotics too often can cause bacteria to become resistant to the medication.

The doctor will make a decision on whether antibiotics are needed. Your doctor will advise you on treatments to lessen pain from an ear infection. The common pain medications used are Panado or Brufen.

 Anaesthetic drops may be used to relieve pain if the eardrum doesn’t have a hole or tear in it. Antibiotic therapy is usually recommended if the symptoms persist for at least 48 hours or if temperature is 38ºC or higher.

Children younger than six months with confirmed acute otitis media are more likely to be treated with antibiotics without the waiting time. If your child has certain conditions, the doctor may recommend a procedure to drain fluid from the middle ear.

If your child has repeated, long-term ear infections (chronic otitis media) or continuous fluid build-up in the ear after an infection cleared up (otitis media with effusion), the doctor may advise this.

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