Signs and Symptoms of Ear Infection

An ear infection occurs when bacteria, fungi, or viruses get trapped in the ear, leading to inflammation and the buildup of fluids. You can have an ear infection that affects the outer ear and the middle ear—though middle ear infections (otitis media) are the most common.

Ear infection symptoms can vary, depending on which part of the ear you develop the infection. Common symptoms include ear pain, hearing loss, fluid drainage, and feeling pressure or fullness in the ear. While some people may experience a rapid onset of severe symptoms, others may have a more gradual progression of symptoms.

Middle Ear Infection Symptoms 

A middle ear infection—or otitis media—develops when viruses or bacteria enter the space behind the eardrum, causing inflammation and fluid buildup. Symptoms commonly associated with a middle ear infection include:

• Ear pain: This pain can range from mild discomfort to severe, sharp pain in the affected ear. Lying down and changes in altitude (e.g., flying on a plane) can worsen the pain. 
• Ear discharge: If fluid builds up in the ear, fluid or pus may drain out from your ear. In most cases, the fluid appears to be yellow or clear, and can often smell bad.
• Hearing difficulties: The accumulation of fluid and inflammation in the middle ear can interfere with your ear's ability to process normal sound transmission. As a result, you might hear muffled sounds or problems hearing in the affected ear. 
• Ear fullness or pressure: A sensation of fullness or pressure in the affected ear may feel similar to being underwater or plugging your ears.
• Fever: As your body fights the infection, a fever can develop. Fevers are especially common in children.

Outer Ear Infection Symptoms 

An outer ear infection—also called otitis externa or swimmer's ear—is inflammation and infection of the ear canal, which is the outer part of the ear that leads to your eardrum. Water that stays in the external ear canal for too long creates an environment for bacteria to grow, which can lead to infection.

Common symptoms of an outer ear infection include:

• Ear pain: Intense pain or discomfort when the earlobe or tragus (the small flap at the front of the external ear canal) is touched or pulled on. 
• Itching and irritation: Persistent itching or irritation in the ear canal.
• Redness and swelling: The infected ear canal may appear swollen and inflamed. On lighter skin tones you may notice that the ear is turning pink or red, while on darker skin tones, your ear may look dark red or brown. Oftentimes, this swelling can also feel tender when touched. 
• Discharge: Pus or clear fluid may drain out of the ear you have the infection in.
• Ear blockage or fullness: Inflammation and swelling can cause a sensation of fullness in the affected ear, which can temporarily affect how you hear.
  

Symptoms in Children

Anyone can develop an ear infection, but infants and children experience ear infections most commonly. In fact, nearly five out of six children will have at least one ear infection by age 3.

Ear infection symptoms in children are similar to symptoms in adults. Young children who cannot verbalize how they are feeling may exhibit additional symptoms, such as:

• Tugging at their ear 
• Fussiness
• Fever
• Trouble sleeping
• Nausea
• Vomiting 
• Decreased appetite 
• Less energetic than usual 
• Balance troubles (e.g., clumsiness) 
• Hearing problems (e.g., not responding to sounds) 
  

When to See a Healthcare Provider 

Most ear infections go away within two to three days. Generally, you can manage your or your child's symptoms at home with comfort measures such as over-the-counter pain relievers. 

Symptoms that warrant a trip to a healthcare provider include:

• Persistent or severe ear pain that lasts for more than 48 hours
• Hearing difficulties that persist for more than a few days 
• High fever
• Pus or blood draining from the ear 
  

Certain signs may indicate a more serious condition that requires prompt medical attention. Seek emergency care if you or your child have any of the following symptoms:

• Sudden and severe onset of ear pain, dizziness, vertigo, or any other symptoms that significantly impact your ability to function
• Significant hearing loss in one or both ears 
• Facial weakness or paralysis on one or both sides of the face 
• Neck stiffness
• Severe headache 
  

If you are unsure about the severity of your symptoms or have any concerns, it is always best to err on the side of caution and consult a healthcare provider. They can perform a physical examination, provide a diagnosis, and recommend the appropriate treatment to help you reduce symptoms.

A Quick Review 

Ear infections can occur in the outer and middle ear. Each of these infections have distinct symptoms. Middle ear infections often cause ear pain, discharge, and hearing difficulties. Outer ear infections cause symptoms like itching, redness, and muffled hearing.

Keep in mind: children can't always explain the pain they're in when they have an ear infection. While symptoms of an ear infection in children are similar to those of an adult's ear infection, your child may also feel fussy, have trouble sleeping, or be lethargic.

Most of the time, ear infection symptoms can be managed at home. However, certain symptoms like severe pain, high fever, sudden hearing loss, or facial weakness, require immediate medical attention.