Ear Infections

All three parts of the ear can develop problems. The vast majority of problems relate to infection or inflammation of the ear.


The Discharging Ear

When an ear starts to discharge it usually means that there is an infection present. The infection usually affects the middle ear but it can sometimes happen when there is an outer ear infection. Outer ear infections, however, more commonly cause pain and are therefore dealt with in more detail under the heading ‘Earache’. In this section the focus is on infections of the middle ear.

There are two important types of middle ear infection (also called otitis media). The commonest is called acute otitis media. The other type is called chronic otitis media. The main difference is the length of time the symptoms have been present. Acute otitis media usually lasts a few days. Chronic otitis media lasts longer than 3 months. The underlying cause of the two types is different.


Acute otitis media

Acute otitis media is the usual cause of ear infections in children although it can affect adults. It is usually a viral infection but can be bacterial. There is usually a high temperature and you feel generally unwell. There is usually earache on one side. There can also be discharge from the ear. Young children can not tell you that they are in pain. They usually pull at the ear instead. The flow chart below shows how acute otitis media develops.

Flowchart showing how Otitis Media develops
Flowchart showing how Otitis Media develops

Most cases of acute otitis media get better without any treatment other than pain killers like paracetamol or ibuprofen. If the symptoms are not getting better after a week your doctor will usually recommend a course of antibiotics. This usually settles any severe infections down. If the symptoms persist despite this your doctor may consider referring you to a specialist.


Chronic otitis media

  • Due to a perforated ear drum
  • Due to cholesteatoma

How to Tell the Difference Between Types of Ear Infection

It is often possible to tell which type of ear infection has occurred from the symptoms and it is almost always possible to make a diagnosis by looking in the ear with an otoscope. The table below shows the common features of the different types of ear infection.

Differential Diagnosis Ear Problems
Differential Diagnosis Ear Problems