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Causes
By Mayo Clinic staff
An ear infection is caused by a bacterium or virus in the middle ear. This infection often results from another illness — cold, flu or allergy — that causes congestion and swelling of the nasal passages, throat and eustachian tubes.
Role of eustachian tubes
The eustachian tubes are a pair of narrow tubes that run from each middle ear to high in the back of the throat, behind the nasal passages. The throat end of the tubes open and close to:
- Regulate air pressure in the middle ear
- Refresh air in the ear
- Drain normal secretions from the middle ear
Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory infection or allergy can block them, causing the accumulation of fluids in the middle ear. A bacterial or viral infection of this fluid is usually what produces the symptoms of an ear infection.
Ear infections are more common in children, in part, because their eustachian tubes are narrower and more horizontal — factors that make them more difficult to drain and more likely to get clogged.
Role of adenoids
Adenoids are two small pads of tissues high in the back of the nose believed to play a role in immune system activity. This function may make them particularly vulnerable to infection and inflammation.
Because adenoids are near the opening of the eustachian tubes, inflammation or enlargement of the adenoids may block the tubes, thereby contributing to middle ear infection. Inflammation of adenoids is more likely to play a role in ear infections in children because children have more active and relatively larger adenoids.
Related conditions
Conditions of the middle ear that may be related to an ear infection or result in similar middle ear problems include the following:
- Otitis media with effusion is inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. This may occur because the fluid buildup persists after an ear infection has resolved. It may also occur because of some dysfunction or noninfectious blockage of the eustachian tubes.
- Chronic suppurative otitis media is a persistent ear infection that results in tearing or perforation of the eardrum.
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- Gould JM, et al. Otitis media. Pediatrics in Review. 2010;31:102.
- Ear tubes. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/Ear-Tubes.cfm. Accessed Jan. 9, 2013.
- Benzocaine topical products: Sprays, gels and liquids — risk of methemoglobinemia. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250264.htm. Accessed Jan. 9, 2013.
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- Tahtinen PA, et al. A placebo-controlled trial of antimicrobial treatment for acute otitis media. New England Journal of Medicine. 2011;364:116.
- Ear infections. Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/antibiotic-use/uri/ear-infection.html. Accessed Jan. 9, 2013.
- Coker TR, et al. Diagnosis, microbial epidemiology and antibiotic of acute otitis media in children. Journal of the American Medical Association. 2010;304:2161.
- American Academy of Pediatrics. The diagnosis and management of acute otitis media. Pediatrics. 2013;131:e964. http://pediatrics.aappublications.org/content/early/2013/02/20/peds.2012-3488
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