How to Tell if You Have an Ear Infection
If you're experiencing ear pain you may be wondering if it's an ear infection and what you need to do about it. This article will help you understand the different types of ear infection you may have, their causes, and your treatment options.
Before we dive in, if your ear pain has lasted more than two days you should book an appointment with a doctor, you may have a bacterial infection and need antibiotic treatment before it gets wrose.
Read on to learn more about how to tell if you have an ear infection.
How to Tell if you Have a Middle Ear Infection
Infections in the middle ear, also called acute otitis media, are the most common ear infection - especially in children.
Pressure in the middle ear is regulated by the Eustachian tubes, which connect the middle ear to the area of the throat behind the nose. The Eustachian tubes maintain a clean and dry airspace within the middle ear by ventilating and draining out accumulated fluids or debris. When airflow is restricted to the middle ear (caused by swelling of, or blockage within the Eustachian tubes), fluid can build up and the middle ear becomes susceptible to infection.
The most common cause of middle ear infections is the common cold or flu. So if you've just had a cold or the flu and are now experiencing ear pain it's likely you have a middle ear infection. If you've had ear pain for more than 2 days you should see a doctor your infection may be bacterial and require antibiotics.
Other causes of middle ear infection may include:
- Viral Infections – As mentioned above, the most common cause is the common cold or flu. Other forms of upper respiratory infections can also cause swelling of the Eustachian tube, which affects the tube's ability to deliver regular airflow to the middle ear.
- Allergies – Allergies to pollen, food, or animal dander can be one of the causes of ear infections. One symptom of these types of allergies is obstruction of the Eustachian tubes, similar to the common cold or flu. In some cases, exposure to smoke, fumes and various types of airborne toxins can cause swelling in the Eustachian tube and be what causes ear infections.
- Bacteria - In rare circumstances where the immune system is lowered by other diseases, bacteria can be what causes an ear infection. In such cases, bacteria often attack the middle ear after a viral infection or an allergy. Bacteria can cause damage to the middle ear often triggering high fevers and hearing loss.
Symptoms of Middle Ear Infection:
Ear infection signs can be different when comparing children and adults. The symptoms of ear infection in adults are:
- Sharp and sudden pains in the ear
- Dull and continuous pains in the ear
- A sharp stabbing pain with immediate warm discharge from the ear canal
- Feeling like your ear is clogged
- Reduced hearing
In children, the symptoms are:
- Constant pulling, tugging, or scratching the ears
- Consistently poor sleep
- Regular fever of 100 °F or higher
- Difficulty responding to sounds
- Constant restlessness
- Ear drainage
- Constant poor appetite
- Increased irritability
- Crying at night when lying down
How to Tell if you Have an Outer Ear Infection
Infection in the outer ear canal, known as otitis externa, is often caused by bacteria that grows within the ear canal. Fungal infections can occur, but are less common. Bacterial and fungal infections both occur when water, sand, or other debris irritate the ear canal. Often this occurs after swimming, which is where otitis externa earned its popular name “swimmer’s ear.”
Outer ear infection causes may include:
- Too much moisture in the ear – Bacteria like water. When excess water remains in your ear canal after swimming, showering, sweating, or from excessively humid weather; bacterial infections are more likely to occur.
- Scratches, abrasions, or other irritations to the ear canal – The skin inside the ear canal is very sensitive and small perturbations can cause irritation or temporary damage. If that occurs, bacteria will be more likely to grow inside the ear canal. "Cleaning" earwax out of the ear using cotton swabs or hairpins is not recommended as it can cause irritation of the ear canal and causes ear infections. Furthermore, using cotton swabs is most likely to push earwax further into the ear canal causing blockage and reduced hearing. Other objects that irritate the ear canal and can cause ear infections include: fingers, headphones, hearing aids, and ear plugs. Do not use ear candles to clean out earwax, they can result in burns and other issues. If you are concerned about excessive earwax, there are appropriate methods for cleaning earwax.
- Sensitivity reactions – Other materials can irritate the ear canal such as hairspray and jewelry. Jewelry can be irritating for persons with eczema or allergies.
Risk factors for otitis externa include narrow ear canals, warm and humid climates, eczema, and little to no earwax. Swimming is the most common cause of outer ear infections, particularly when swimming in water with high bacteria counts. Children are somewhat more susceptible to outer ear infections compared to adults because their ear canals are smaller, making proper drainage more difficult. Irritation of sensitive skin cells in the ear canal can be caused by headphones, ear plugs, or hearing aids – leading to increased likelihood of infection in the ear canal.
Symptoms of outer ear infection:
- Pain, which can be very intense
- Worsened pain if the pinna is pulled (a particularly helpful test to tell if you have an outer ear infection)
- Worsened pain while chewing
- Drainage of yellowish-brown discharge (sometimes foul smelling)
- Feeling of fullness within the ear
- Red or swollen ear canal or in severe cases, that of the pinna
- Reduced hearing from build up of discharge or swelling of the ear canal
How to Tell if you Have Inner Ear Infection
Labyrinthitis is the swelling and inflammation of the inner ear, which can be caused by viral or bacterial infection. A bacterial infection is more rare and might be the result of bacteria spreading from a middle ear infection into the inner ear.
Causes of inner ear infection:
- Cold or Flu viruses – The most common causes of ear infections in the inner ear are cold and flu viruses. They can spread from the respiratory system into the middle ear and then into the inner ear.
- Other viruses – There are less common viral causes of ear infections including measles, herpes, mumps, and glandular fever.
- Complications of a middle ear infection – A middle ear infection can spread into the inner ear. This is the most common cause for a bacterial infection in the inner ear.
- Ear damage after a head injury – Injury to the ear or head can expose the inside of your body to unwanted bacteria.
Symptoms of labyrinthitis include:
- Reduced hearing or hearing loss
Diagnosing Ear Infections
If the doctor finds evidence of infection, you are likely to get one of the following diagnoses:
- Acute otitis media. Your doctor makes this diagnosis if they observe signs of fluid in the middle ear, if there are signs or symptoms of an infection, and if the onset of symptoms was relatively sudden.
- Otitis media with effusion. The doctor has found evidence of fluid in the middle ear, but there are presently no signs or symptoms of infection.
- Chronic suppurative otitis media. The doctor found that a persistent ear infection resulted in tearing or perforation of the eardrum.
- Acute otitis externa. Such a diagnosis indicates an infection in the outer ear, most likely in the ear canal. This type of infection can be bacterial or less commonly fungal, and is often diagnosable by sensitivity to pulling on the ear, or visual identification of fungal colonies. If there is an infection in the middle ear that has caused a perforation of the eardrum such as in a case of chronic suppurative otitis media, the visual appearance could be similar to an example of acute otitis externa and the two could be difficult to distinguish.
- Labyrinthitis. This diagnosis indicates swelling and inflammation of the labyrinth, potentially caused by infection in the inner ear. Most commonly labyrinthitis is caused by a virus, but bacterial infections can also spread from the middle ear to the inner ear during otitis media. Part of the function of the inner ear includes balancing your body. As such, an infected inner ear can affect one’s balance causing vertigo and dizziness.
If you are still unsure how to know if you have an ear infection then you may consider reading more about other issues that can cause earaches such as:
When to See a Doctor
Ear infection signs and symptoms can indicate a number of conditions. It's important to get an accurate diagnosis and prompt treatment. Call your doctor if:
- Symptoms last for more than a day or two
- Symptoms are present in a child less than 6 months of age
- Ear pain is severe
- Your infant or toddler is sleepless or irritable after a cold or other upper respiratory infection
- You observe a discharge of fluid, pus or bloody discharge from the ear
- Your child develops stiff neck, a condition where children cannot move their neck due to sharp neck and back pain
Should any of these symptoms continue or worsen make an appointment with your
primary care physician or see an urgent care doctor immediately.
Read more from our Ear Infection Series:
Ada. Signs of Ear Infection. Accessed online February 16th, 2018 at
Healthline. Ear Infections. Accessed online February 16th, 2018 at
Mayo Clinic. Ear Infection (middle ear). Accessed Online February 16th, 2018 at