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Middle ear infection (acute otitis media) fact sheet

Middle ear infection (acute otitis media)

What is a middle ear infection (acute otitis media)?

A middle ear infection, otherwise known as acute otitis media (AOM), is an infection behind the ear drum which can be caused by bacteria and/or viruses. It is more common in young children as it is easier for an infection to travel up the throat and into the middle ear in a developing ear.

Middle ear diagram

Children who are exposed to cigarette smoke, go to day-care, or use a dummy are more likely to contract a middle ear infection.

What are the signs and symptoms?

  • Ear pain – children will often tug or rub their ear and cry at night.
  • Fever – temperature over 38°C.
  • Generally unwell e.g. runny nose, sore throat or cough.
  • Fluid or blood leaking from the ear (this is a sign of a ruptured ear drum).

How is it diagnosed?

A doctor can diagnose a middle ear infection by examining the ear using a special instrument with a magnifying lens and a torch. You will be asked to assist with the examination by holding your child sideways with their head held onto your chest and your other arm around their arms.

Sometimes a small hole (perforation) in the ear drum can be seen in children with fluid coming out of their ear/s. Redness inside the ear does not always mean your child has a middle ear infection.

What is the treatment?

Middle ear infections are treated with medicine to help with the pain. Give your child paracetamol (Panadol) and/or ibuprofen (Nurofen). Occasionally, stronger pain relief is needed. Your doctor will tell you if your child needs additional pain medication.

Most infections are mild and will get better without any other treatment in one or two days. A small number of children who have a bacterial infection will be given antibiotics. Other medications such as antihistamines and decongestants will not help treat a middle ear infection.

Children who have fluid in their middle ear for a long time, often get ear infections, or are having problems hearing may need to see a specialist. Your GP will advise if this is needed.

When to seek medical help

You should see your GP immediately if your child has:

  • symptoms of a middle ear infection and is less than six months old
  • symptoms of a middle ear infection for more than two days
  • a lot of ear pain, or swelling and redness in the bony area behind the ear
  • fluid leaking from the ear.

All children with a middle ear infection should see their GP three months after the pain has settled to make sure all the fluid is gone.

Care at home

Give your child regular medication to help with their pain. Follow the instructions on the bottle for the right dose for your child. Do not give more than the recommend number of doses in a day.

Children with a ruptured ear drum should not get any water in the ear until the perforation has healed (usually takes about 10 days). A doctor will need to check your child’s ear to see if the perforation has healed.

Air travel can make the symptoms worse. Children are usually safe to fly two weeks after they have recovered from middle ear disease. Please see your GP if your child needs to fly earlier.

Key points to remember

  • Middle ear infections are very common in young children.
  • Middle ear infections causes ear pain which can usually be managed with Panadol or Nurofen.
  • The pain and fever usually goes away in one to two days without needing antibiotics.
  • See your doctor if you are concerned about your child, if there is fluid leaking from their ear, or if there is swelling and redness in the bony area behind the ear.

Further information

In an emergency, always call 000 immediately. Otherwise, contact your local doctor or visit the emergency department of your nearest hospital. For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.

Resource No: FS166 developed by Ear, Nose and Throat and Emergency. Updated: June 2018. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health. Picture supplied with permission by Victoria Health.

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