Acute otitis media: Causes, symptoms and prevention

otitis media prevention

Acute otitis media refers to an infection of sudden onset that usually presents with ear pain and swelling. Acute otitis media occurs when a cold, allergy, or upper respiratory infection, and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube.

Although acute otitis media can occur at any age, it is most common between the ages of 3 months and 3 years. Acute otitis media often occurs during this age range because structures in the middle ear, such as the eustachian tube, are immature and not functioning properly.

Ear infections do not spread from person to person and they most commonly occur with a cold.

otitis media ear infection
Otitis media

Some conditions of the middle ear that may be related to an ear infection or result in similar middle ear problems such as:

  • Otitis media with effusion It is defined as the presence of non-infectious fluid in the middle ear for more than three months. In most cases, there’s inflammation and fluid buildup in the middle ear without bacterial or viral infection. This may occur because the fluid buildup persists after an ear infection has resolved. It may also occur due to some dysfunction or non-infectious blockage of the eustachian tubes.
  • Chronic otitis media with effusion is middle ear inflammation of greater than two weeks that results in episodes of discharge from the ear. It may be a complication of acute otitis media. This makes children susceptible to new ear infections and may affect hearing.
  • Chronic suppurative otitis media is a persistent ear infection that often results in tearing or perforation of the eardrum.

Causes of acute otitis media

The common cause of all forms of otitis media is dysfunction of the Eustachian tube. It occurs when your child’s eustachian tube becomes swollen or blocked and traps fluid in the middle ear. The trapped fluid can become infected.

The eustachian tube can become swollen or blocked for several reasons such as:

  • allergies
  • a cold
  • the flu
  • a sinus infection
  • infected or enlarged adenoids
  • not being breast-fed
  • bottle-feeding while lying down
  • exposure to second-hand smoke
  • family history of recurrent acute otitis media

Signs and symptoms

Some of the common symptoms of otitis media that a parent should look out for are:

  • Fever
  • Irritability
  • Loss of appetite
  • crying
  • ear pain
  • pulling on the ears
  • sleeplessness
  • irritability
  • fluid drainage from the ear
  • feeling of fullness in the ear


In most cases, an instrument called otoscope is used to examine the ear canal and eardrum. In an infected ear, the eardrum usually appears red and swollen and pus may be seen behind the eardrum, which is usually clear and translucent.

When fluid or pus builds up in the middle ear, the doctor can perform a tympanometry. This is a simple hearing test that measures the pressure on both sides of the eardrums.


Most people with acute otitis media get better without treatment. However, because it is hard to predict whose symptoms will not lessen, some doctors treat all people with antibiotics, such as amoxicillin, ceftriaxone.

Pain relief is important. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can relieve pain.

Antihistamines are useful for people who have allergies but not for those with colds. Decongestants and antihistamines are not helpful for children and may cause bothersome and possibly dangerous side effects, particularly in children younger than 2 years.

Home treatments can also be used such as:

  • applying a warm, moist washcloth over the infected ear
  • using over-the-counter (OTC) ear drops for pain relief
  • taking OTC pain relievers such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol)


The following tips may reduce the risk of developing ear infections:

  • Prevent common colds and other illnesses. Teach your children to wash their hands frequently and thoroughly and to not share eating and drinking utensils. Also, teach your children to cough or sneeze into their arm crook.
  • Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.
  • Breast-feed your baby. If possible, breast-feed 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. Avoid propping a bottle in your baby’s mouth while he or she is lying down. Don’t put bottles in the crib with your baby.

About felclinic 592 Articles
Felix Ntifo is a Registered General Nurse who has so much passion to improve health care delivery. He founded FelClinic with the hope of making health information accessible to everyone who may not come in contact with him personally. "At we are very passionate about health and well-being of everyone. Our team is made up of professional doctors, nurses, midwives and lab technicians."

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