Ear infections can be caused by bacteria and fungi typically. Rarely can viruses be responsible.
Otitis is the technical term used for ear infections. Otitis is a word derived from Latin and means inflammation in the ear.
Ear infections can be classified broadly based on the location of the infection. An ear can be divided into three parts: the outer ear canal, the middle ear, and the inner ear.
The most common ear infection is the bacterial middle ear infection, known as otitis media. In fact, it is one of the most commonly occurring infections in the body.
Neglecting an ear infection can lead to its spread within the ear, potentially causing permanent hearing loss. That's why detecting and treating the infection early on is crucial to avoid any further complications. In this article, we will briefly describe every ear infection so that you are well aware of the possible types of ear infection and their causes.
Types of ear infections
Ear infections can be divided into three parts:
Inner ear infections - Otitis interna
Outer ear infections - Otitis externa
Middle ear infections
Otitis media, or middle ear infection, often arises when issues in the nasopharynx (the back part of the nose) block the eustachian tube or allow infected fluids to enter the middle ear. The eustachian tube regulates air pressure in the middle ear, and disruptions can lead to infection.
A cold, a common nasal infection, can spread to the middle ear if untreated, making middle ear infections quite prevalent.
Types
Acute Suppurative Otitis Media or Acute Otitis Media
Serous Otitis Media
Otitis Media with Effusion
Acute suppurative otitis media
Chronic Suppurative Otitis Media or Cholesteatoma
Causes
Middle ear infections, or otitis media, are secondary infections caused by infections that affect the back of the nose (nasopharynx), like the common cold and sinusitis. The middle ear is connected to a eustachian tube that ends in the back of the nose. The middle ear gets air supplied through this tube. So, when there is any blockage in this tube, the fluids will get collected in the middle ear leading to a middle ear infection. The fluid can even stagnate when there is negative pressure in the ear. The ear has the capacity to absorb the air, and it requires a constant supply of air as it constantly absorbs the air. But when the ear or eustachian tube is blocked, there will be no air supply into the middle ear leading to negative pressure. When there is negative pressure, the fluids seep into the middle ear from the skin lining. Because of these, the fluids will stagnate, and create a conducive environment for bacteria to grow, resulting in middle ear infections or otitis media.
Here we have a list of conditions that can cause middle ear infections.
The untreated common cold is a frequent cause of middle ear infections since it's one of the most common infections in the human body.
Blowing your nose forcefully, especially when one nostril is blocked, can create high pressure in the back of your nose (nasopharynx) and push fluids into the middle ear.
Smoking, whether actively or being exposed to secondhand smoke, can cause inflammation in the lining of the nose. This inflammation can travel back into the eustachian tube and lead to a blockage, resulting in a middle ear infection.
Chronic sinusitis can cause fluids from the sinuses to seep into the nasopharynx, which can then enter the middle ear and cause an infection. Click here to know more.
Allergies that affect the lining of the nose, throat, breathing pathway, lungs, voice box, nasopharynx, and eustachian tube can create a blockage in the eustachian tube, potentially triggering a middle ear infection.
Extra growths or tumors in the nasopharynx can block the opening of the eustachian tube, creating negative pressure in the middle ear and leading to otitis media (middle ear infection).
Adenoids, which are extra growths in the back of the nose, are a common cause of middle ear infections in children. They can block the opening of the auditory tube, causing a middle ear infection.
Sudden changes in air pressure, such as rapidly ascending to high altitudes, using high-speed elevators in tall buildings, diving into water, or traveling by airplane, can cause a mismatch in air pressure between the middle ear and the atmosphere. This can trigger a middle ear infection, especially if the eustachian tube is partially blocked due to allergies or other mentioned causes.
Feeding habits in babies can cause ear infections as eustachian tubes are more horizontally aligned due to the limited space in babies' head. This positioning makes it easy for milk to travel to the eustachian tube and enter the middle ear. Click here to know more.
Symptoms
Otitis media symptoms are
Severe ear pain
Fever
Ear discharge
Deafness or block sensations
As the middle ear is in between the outer ear and the inner ear, the disease can spread to the adjacent parts showing additional symptoms.
Treatment
As the middle ear infection is secondary, the primary cause needs to be treated for any treatment to be effective. Antibiotics, as per the type of infection, are given as the infection is bacterial.
It's essential to consult an ENT doctor for a proper treatment prescription. Incorrect diagnosis, self-medication, and reliance on home remedies may aggravate the condition, particularly in cases of otomycosis.
Prevention
Always treat the common cold by using nasal drops, steam inhalations can prevent the infection from spreading to middle ear.
Don’t blow your nose when you have common cold especially one nostril is blocked.
Treating chronic sinusitis
Avoid smoking
Take anti-allergic medication when you have allergies. They will not only bring down the mucus secretions in your nose but can decrease the inflammation in the mucosa lining that ends up fully or partially blocking the eustachian tube.
Try to gulp your saliva whenever you experience sudden pressure changes.
Outer ear infections - Otitis externa
Otitis externa is an infection of the ear canal, the external part of the ear that collects sound and directs it to the middle ear. Due to its exposure to the environment, the outer ear is susceptible to infections from bacteria, fungi, viruses, or other substances.
This is the second most common type of ear infection.
Types of Otitis Externa
Affects a larger area in the ear canal.
Includes conditions like Swimmer's Ear and Otomycosis.
Commonly caused by Pseudomonas aeruginosa bacteria or fungi like Aspergillus Niger and Candida. In many cases both fungal and bacterial infections could exist together.
Localized to a small area at the end of the ear canal.
Caused by Staphylococcus aureus bacteria.
Often begins as a pimple or boil in the outer ear.
Causes of Outer Ear Infections
Bacterial Infections: Common in non-humid areas.
Viral Infections: Myringitis bullosa hemorrhagica is a rare type affecting the outer ear canal. It is often susceptible to misdiagnosis as acute otitis media.
Swimmer’s Ear: Inflammation of the ear canal due to exposure to chlorinated or contaminated water.
Symptoms
Itchy ears (common with fungal infections).
Ear pain.
Discharge from the ear, indicating perforation of eardrum
Hearing loss due to eardrum perforation.
Treatment
Always consult an ENT doctor for proper diagnosis and treatment.
Do not self-diagnose or use over-the-counter remedies without professional guidance.
Prevention
Avoid using external objects to clean ears, especially after bath.
Don’t put oil into ear, as it can promote fungus growth.
Don’t use antibiotic ear drops or any other ear drops without a prescription.
Avoid home remedies and always consult a doctor for any issue with ear.
Always use proper protection for ears while swimming
Inner ear infections
The inner ear, the innermost part of the hearing system, plays a crucial role in hearing and maintaining the balance of our body. Inner ear infections are always secondary infections, usually spread from adjacent structures. Two common types of inner ear infections are vestibulitis and labyrinthitis.
This infection, if neglected, can spread to the brain.
Types
Vestibulitis
Vestibulitis is a disease in the inner ear that affects the vestibular part of the labyrinth. The labyrinth is responsible for maintaining the balance of the body. So, when the infection spreads to this part, causing vestibulitis following symptoms can be observed.
Nausea
Vomiting
Giddiness, loss of balance in the body
Labyrinthitis
In labyrinthitis, hearing and balance are affected as the entire labyrinth is involved, unlike vestibulitis. So the symptoms can be listed as
Nausea
Vomiting
Giddiness, loss of balance in the body
Severe Hearing loss
Tinnitus
Causes
Inner ear infections can occur under two circumstances:
Middle Ear Infections Spreading: The most common cause of inner ear infections is when infections originating in the middle ear spread to the inner ear. This is a typical route for ear infections to reach the inner ear.
Infections from the Brain Spreading: Inner ear infections can also be caused by infections spreading from the brain. Meningitis and Encephalitis are conditions that can lead to an inner ear infection. However, it's important to note that this cause is quite rare.
Symptoms
As the inner ear has two functions hearing and maintaining balance. Both these functions will be affected, causing.
Loss of hearing
Blockage of ears or clogged sensation
Tinnitus
Giddiness, loss of balance
Vomiting
Treatment
The treatment for an inner ear infection typically involves a combination of antibiotics given at a higher dosage than usual, followed by the administration of steroids. Once the infection reaches the inner ear, the treatment approach becomes more aggressive due to the rapid progression of the disease.
In response to the infection, our body acts defensively by forming a protective bone around the inner ear. This condition is called labyrinthitis ossificans. This serves as a barrier to prevent the infection from spreading to the brain or nearby structures. However, if this bone formation process is completed, it can result in permanent damage to that side of the ear. Unfortunately, there is no known method to reverse this condition.
If the bone formation process begins, immediate cochlear implant surgery becomes the only option to halt its progress and preserve hearing function. This surgical intervention can help prevent further damage and provide a means of hearing assistance.
Prevention
Treating ear infections on time can prevent the spread of the disease to the inner ear. In fact, it is very crucial once the infection reaches inner ear.
Who are at risk of developing an ear infection?
Ear infections can impact people across all age groups. However, specific factors can heighten the likelihood of developing such infections. Here are several prevalent risk factors to consider:
An individual who gets repeated cold attacks is at risk of developing an ear infection.
An individual who cleans their ear, especially after the bath, is at risk of developing an ear infection.
Swimmers who clear their ears after the swim.
An individual with adenoids is always at high risk.
Any disease in the nasopharynx and nose will increase the risk of middle ear infection.
Wrong feeding habits can increase the risk of developing ear infections in babies.
It's important to remember that while these factors may increase the risk of ear infections, they don't guarantee that an individual will develop an infection. Proper immunity, maintaining a healthy lifestyle, and seeking prompt medical attention for respiratory infections can help reduce the risk of ear infections.
Symptoms that will help you identify an ear infection
Ear infections can manifest with various symptoms, which can differ based on the type of infection and the specific area of the ear affected. Here are some typical symptoms that are often associated with ear infections:
Ear pain
Tinnitus
Ear block sensation or deafness
Pus from ear
Itching in the ear
Foul smelled watery discharge from the ear
Giddiness, loss of balance
Vomiting
To know more about these symptoms, please check out our article "Symptoms of an ear infection." This article will help you understand ear infection symptoms according to their types and help you identify your ear infection.
Complications
While most ear infections resolve without any complications, in some cases, complications can arise. Here are some potential complications associated with ear infections:
The infection can spread to the ear bones or temporal bone causing complications like abscesses and swelling in the back of the ear.
It can create complications in the adjacent structures or neck.
The ear infection can spread to the brain, causing meningitis and encephalitis.
If the infection spreads to the facial nerve, it will create complications like paralysis of the face, which can restrict eye closure.
If the infection spreads to the tongue's nerves, we can't speak and swallow properly.
If it spreads to the nerves of the throat, it will create complications like swallowing the food, which goes into the lungs instead of the food pipe.
How to prevent an ear infection?
Here are some prevention tips for preventing ear infections:
Avoid using objects like cotton buds, pins, keys, etc., to clean or scratch your ear.
Treat sinusitis and common cold properly on time.
Don't blow your nose when you have the common cold.
When you have a common cold taking steam inhalations can reduce the risk of developing ear infections.
Plug your ears while swimming to avoid chlorinated and toxic water.
Avoid cleaning your ears after swimming.
Following these prevention tips can reduce the risk of ear infections and their complications and promote your overall ear health. It's important to remember that individual susceptibility to ear infections can vary, and some factors may be beyond your control. So, if you or your child experience persistent ear infections, consult an ENT doctor for further evaluation and guidance.
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FAQs
What is the most common ear infection?
The most common ear infection is otitis media, a bacterial infection in the middle ear. In fact, it is among the most common conditions that can occur in the human body. Its a secondary infection and can be triggered due to multiple causes.
Can ear infections damage the brain?
Yes, untreated ear infections can lead to complications such as meningitis and encephalitis, which may damage the brain. Nevertheless, such complications are rare, and most ear infections can be resolved with proper care.
What is the first line antibiotic for ear infections?
The choice of first-line antibiotics for ear infections varies based on the type of infection and individual factors. Doctors typically determine it after diagnosing the specific situation.
What diseases can occur in the ear?
Various diseases and conditions can impact the ears, affecting hearing and balance. Some common ear diseases include otitis media, otitis interna, outer ear infections, otomycosis, circumscribed otitis externa, swimmer's ear, bullous myringitis, cholesteatoma, otosclerosis and otospongiosis.
Where does an ear infection start?
Ninety percent of ear infections start in the middle ear and are secondary infections. They are often caused by a common cold or chronic sinusitis that spreads from the nose. These middle ear infections are called Otitis Media, so most ear infections start as Otitis Media.
The second most common type of ear infection, otitis externa, begins in the outer ear canal. In extremely rare cases, infections can spread from the brain to the inner ear, a condition called otitis interna.
It's important to note that an infection in one part of the ear can spread to other parts.
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