Ear infection evaluation

Treatment depends on the type and severity of the ear infection. The immune system can often clear mild middle ear infections on its own. Antibiotics are recommended if symptoms are severe, if the child is very young or if symptoms last more than two to three days without improvement. Rest, extra fluids and over-the-counter pain or fever medicine (such as acetaminophen or ibuprofen, used exactly as directed and with age-appropriate guidance) are recommended.

Home remedies such as oils or herbal drops are not recommended without health care consultation. Safe symptom relief most often includes rest and hydration.

Common symptoms of middle ear infections (children and adults) are: 

• Ear pain
• Fever
• Fussiness or irritability (especially in young children)
• Rubbing or tugging at the ear
• Difficulty sleeping
• Sometimes hearing problems or a sense of muffled hearing

Young children may show:

• Changes in sleeping or eating habits
• Increased crying or irritability
• Ear-tugging or holding the ear
• Fever, sleepiness or trouble sleeping  

In addition to pain, older children and adults may report:

• Fullness or pressure in the ear
• Temporary hearing loss in the affected ear
• General feeling of illness, nasal congestion, cough or other upper respiratory symptoms (often after a cold)  

Symptoms of swimmer’s ear (outer ear infection): 

• Ear pain that worsens when the outer ear is tugged or when pressing on the tragus, the small piece of cartilage located at the entrance to the ear canal.
• Itching inside the ear canal
• Redness and swelling of the outer ear canal
• Drainage from the ear

Symptoms requiring prompt medical evaluation:

• Fluid, pus or blood draining from the ear
• Symptoms lasting more than two to three days
• Hearing loss
• Very high fever

Middle ear infections:

• Can be caused by bacteria, viruses and allergies.
• Viruses that cause colds or other upper respiratory infections (URIs) can also lead to ear infections.

Swimmer’s ear (outer ear infection):

• A bacterial infection of the outer ear canal. Swimming is a common risk factor for developing an outer ear infection because water exposure compromises the ear canal’s natural defenses, which creates a moist environment for bacteria to grow.  
• More likely with frequent swimming, bathing or humid environments.  

Earwax and foreign objects:

• Earwax itself is normal and protective, but impacted or excessive earwax can cause ear pain, fullness, temporary hearing loss and tinnitus.
• Foreign objects in the ear canal can cause irritation, inflammation and secondary infection. They are considered medical issues that should be handled by a provider, not at home.  

An acute ear infection is a single, short-term episode of infection in the middle ear. It often follows a cold or other upper respiratory infection.
Common reasons people keep getting ear infections include: 

• Frequent viral infections (especially in group childcare settings).
• Allergies or chronic nasal congestion that affects eustachian tube function.

Yes. A MinuteClinic provider can evaluate and treat earwax blockage. They will review your medical history, discuss symptoms and examine your ears with an otoscope.

Middle ear infections themselves are not usually spread directly from person to person. Swimmer’s ear, also known as an outer ear infection, is also not contagious. However, other conditions such as upper respiratory infections that sometimes precede ear infections can be contagious.

Yes. Ear infections, especially when chronic or associated with persistent fluid, can cause conductive hearing loss. Typically, ear infections are managed with medication and careful monitoring.

Yes. Tinnitus can be associated with ear infections and other ear problems. If you develop tinnitus with ear pain, with hearing changes or after an ear infection, it is recommended to see a health care provider, especially if:

• Tinnitus is sudden
• Tinnitus is only in one ear or
• It is associated with significant hearing loss, dizziness or neurologic symptoms