What is an ear infection?

When occurring in the middle ear, an ear infection is also called otitis media. Eustachian tubes equalize pressure and allow for drainage from the ears into the nose. Sometimes, with a cold, the flu, or an allergy, Eustachian tubes can become swollen and trap fluid in the middle ear. This fluid becomes the perfect place for bacteria and viruses to grow, which can lead to an infection, usually with inflammatory symptoms.  


What causes ear infections?

Ear infections, which have many causes, are more common during the fall and winter seasons when cold and flu susceptibility is higher. Inflammation and congestion from allergies can also lead to ear infections. For example, people with seasonal allergies, such as pollen allergies, may have a greater risk of ear infections when pollen counts are high because their allergic reactions may cause congestion and inflammation. 

Ear Infection Symptoms

 Common ear infection symptoms include: 

  • Ear pain  
  • Itchy ears
  • Earaches  
  • Fevers 
  • Popping of the ears  
  • Ears feeling clogged, stopped-up,  or full 
  • Diminished hearing 

Infants and children with ear infections may have additional symptoms, such as increased irritability, difficulty sleeping, tugging on their ears, and/or a loss of appetite.  

Ear Infection Treatment

Symptoms of ear infections usually improve within the first couple of days, and most infections clear up on their own within one to two weeks without any treatment. However, some evidence suggests that treatment with antibiotics might be helpful for certain children with ear infections. On the other hand, using antibiotics too often can cause bacteria to become resistant to the medicine. Talk with a healthcare provider about the potential benefits and risks of using antibiotics.1

For pain management, a healthcare provider may advise treatments to lessen pain from an ear infection. These may include pain relievers and anti-inflammatory medications.1 

What is chronic otitis media? 

Chronic otitis media may be defined as a middle ear effusion without perforation that is reported to persist for more than one to three months.2 Also called chronic serous otitis media, it generally occurs gradually over many years in people with long-standing or frequent ear trouble.  

Warning signs of chronic otitis media include:3

  • Hearing loss 
  • Chronic ear drainage 
  • Persistent blockage of fullness of the ear 
  • Development of balance problems 
  • Facial weakness 
  • Persistent deep ear pain or headache 
  • Fever  
  • Confusion or sleepiness 
  • Drainage or swelling behind the ear 

If it is not treated, chronic otitis media may not only cause severe pain but also result in serious complications, including permanent hearing impairment.4

Chronic Otitis Media Triggers and Causes 

Although most of the problems with chronic otitis media are associated with infections, allergic sensitizations can be a risk factor for recurrent episodes of the illness. It is thought that approximately 20 percent of patients with chronic serous otitis media have a contributing underlying allergy.There is also a significant correlation between chronic otitis media and allergic disease.6

Is it an allergy or something else?

So how do you know if allergies are contributing to an ear infection? Paying close attention to presenting symptoms and relaying this information to healthcare providers can help steer them toward  testing  that can identify the relevant sensitizing allergens. This information may be able to help them outline a comprehensive management plan, which may include avoiding known allergens that can keep a person below his or her  symptom threshold. If chronic otitis media is occurring alongside an allergy diagnosis, avoiding potential triggers can be, in and of itself, a promising management strategy.7 


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  1. Mayo Clinic, “Ear infection (middle ear),” https://www.mayoclinic.org/diseases-conditions/ear-infections/diagnosis-treatment/drc-20351622 (accessed August 27, 2021).  
  2. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media – prevention and treatment. Infection and Drug Resistance. 2014;7:15-24. doi:10.2147/IDR.S39637.  
  3. University of Maryland Medical Center [Internet]. Baltimore (MD): University of Maryland Medical Center; 2021. Available from: https://www.umms.org/ummc/health-services/hearing-balance/services/ear-infections.
  4. World Health Organization: Chronic suppurative otitis media Burden of Illness and Management Options. http://www.who.int/pbd/publications/Chronicsuppurativeotitis_media.pdf. Accessed April 2019. 
  5. Tomonaga, K, Kurono, Y, Mogi, G. The role of nasal allergy in otitis media with effusion. A clinical study. Acta Otolaryngol Suppl. 1988;458:41-47.
  6. Passali D, Passali GC, Lauriello M, Romano A, Bellussi L, Passali FM. Nasal Allergy and Otitis Media: A real correlation? Sultan Qaboos University Medical Journal. 2014;14(1):e59-e64.  
  7. Zernotti ME, et al. Otitis media with effusion and atopy: is there a causal relationship? World Allergy Organ J. 2017; 10(1):37.