Conditions and diseases

Acute middle ear infections

Symptoms and causes

Symptoms and causes

What is it?

An acute middle ear infection is an infection of the middle ear that is often accompanied by an upper respiratory tract infection. The infection is usually viral or bacterial.

Characteristics in children

Given the position and anatomy of the Eustachian tube in small children, it does not function as well as it does in older children. As a result, young children are more vulnerable to middle ear infections.

The most common symptoms in children are:

  • pain
  • fever
  • pulling on the ears
  • crying while lying down
  • ear drainage (in case of perforation of the eardrum due to excessive pressure with pus drainage)

Characteristics in adults

The most common symptoms in adults are:

  • pain
  • fever
  • ear drainage

Risk factors

Possible complications are:

  • eardrum perforation with ear drainage
  • hearing loss in the outer and middle ear (conductive hearing loss)
  • cholesteatoma (a type of chronic middle ear infection where skin cells grow inwards towards the middle ear and can cause damage)

More acute complications are:

  • mastoiditis (infection of the bone behind the ear, along with a protruding ear and redness)
  • infection of the spinal fluid (thrombosis of the sigmoid sinus and meningitis)

These more acute complications are usually quite rare.

Diagnosis and treatment

Diagnosis and treatment


Pain medication and fever reducers are used to treat acute middle ear infections. Antibiotics are used in small children who are less than six months old, but also in sick children who do not improve after a few days of observation.

If runny ear develops in children, you can use antibiotic ear drops as treatment. For ear infections that recur quite frequently, ear tubes or tympanostomy tubes, are recommended.

Your physician will discuss the use of grommets with you.

Treatment centres and specialisations

Treatment centres and specialisations

Latest publication date: 14/05/2024
Supervising author: Dr Vermeiren Judith