infections center

What Does the Start of an Ear Infection Feel Like?

Symptoms of ear infections may include ear pain, itching and irritation in and around the ear, discharge from the ear (otorrhea), feeling of fullness or pressure in the ear, scaly skin in and around the ear, ringing in the ear (tinnitus), difficulty hearing/hearing loss, spinning sensation (vertigo), nausea, vomiting, fever, feeling unwell (malaise), and loss of energy.
Symptoms of ear infections may include ear pain, itching and irritation in and around the ear, discharge from the ear (otorrhea), feeling of fullness or pressure in the ear, scaly skin in and around the ear, ringing in the ear (tinnitus), difficulty hearing/hearing loss, spinning sensation (vertigo), nausea, vomiting, fever, feeling unwell (malaise), and loss of energy.

There are different types of ear infections, based on where in the ear the infection occurs. 

Symptoms of ear infections usually start quickly and can include:

  • Ear pain
  • Itching and irritation in and around the ear
  • Discharge from the ear (otorrhea)
    • Commonly caused by otitis externa (“swimmer’s ear”)
  • Feeling of fullness or pressure in the ear
  • Scaly skin in and around the ear
  • Ringing in the ear (tinnitus)
  • Difficulty hearing/hearing loss 
    • Frequently caused by otitis media
  • Spinning sensation (vertigo)
  • Nausea
  • Vomiting 
  • Fever 
  • Feeling unwell (malaise)
  • Loss of energy

In young children and babies, symptoms of ear infections may also include:

  • Pulling or rubbing on the ear
  • Irritability
  • Fussiness
  • Restless sleep
  • Decreased activity
  • Decreased appetite or difficulty eating
  • Diarrhea
  • Not reacting to some sounds
  • Loss of balance

See a doctor right away if you have a known ear infection or an earache and:

  • A high temperature 
  • Chills
  • An earache that does not improve after three days
  • Fluid draining from the ear
  • Hearing loss or changes in hearing
  • Swelling around the ear
  • Other symptoms of illness such as a severe sore throat or dizziness
  • A chronic underlying medical condition, such as diabetes or a heart, lung, kidney or neurological disease
  • A weakened immune system, such as from AIDS, cancer, chemotherapy, or you are taking immunosuppressive medicines

What Causes an Ear Infection?

Ear infections in the outer canal (otitis externa, or “swimmer’s ear”) are caused by:

  • Bacterial or fungal overgrowth in the ear canal caused by moisture mixing with the earwax and debris in the ear canal
  • Moisture can enter the ear from swimming, diving, or even bathing and showering
  • Overuse of cotton swabs in the ear canal 

Ear infections in the middle ear (otitis media) are caused by:

  • Bacteria
    • Common bacterial causes of middle ear infections are Streptococcus pneumoniae (also called pneumococcus), Haemophilus influenzae, and Moraxella catarrhalis
  • Viruses
    • Common viral causes of middle ear infections are respiratory syncytial virus (RSV) and flu (influenza) virus
  • Fluid from the sinuses can back up through the Eustachian tubes that connect the throat to the middle ear, such as when the sinuses or throat are inflamed from infection (from a cold, sinusitis, or an allergy attack) 
    • The backed-up fluid becomes trapped in the middle ear, which is a good breeding ground for bacteria and viruses

How Is an Ear Infection Diagnosed?

  • Ear infections are diagnosed with a patient history and physical examination of the ear with an otoscope, an instrument that is a light with a cone at the tip to visualize inside the ear canal, to check for inflammation in the ear canal. 
  • Tympanometry may also be performed to check for changes in pressure in the middle ear. 

What Is the Treatment for an Ear Infection?

Medications used to treat ear infection include: 

Sometimes, when a middle ear infection is present, a doctor may recommend waiting to see if antibiotics are needed. Home remedies to relieve the symptoms of an earache include: 

  • Rest
  • Drink plenty of fluids
  • Warm compresses applied to the area to help soothe pain
  • Over-the-counter medications 
    • Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol)
    • Decongestants 
    • Allergy medications 
  • Consult your doctor before using over-the-counter pain ear drops
    • Ear Drops should not be used in children with tympanostomy tubes (ear tubes) unless specifically prescribed by a child’s pediatrician.

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References
https://www.uptodate.com/contents/external-otitis-pathogenesis-clinical-features-and-diagnosis?search=otitis%20externa&source=search_result&selectedTitle=2~85&usage_type=default&display_rank=2

https://www.uptodate.com/contents/external-otitis-treatment?search=otitis%20externa&source=search_result&selectedTitle=1~85&usage_type=default&display_rank=1

https://www.uptodate.com/contents/ear-infections-otitis-media-in-children-beyond-the-basics?search=otitis%20media&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3

https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/middle-ear-infection-otitis-media

https://www.nhs.uk/conditions/ear-infections/