Ear infection, inner - Symptoms of middle ear infection

In most cases, the symptoms of a middle ear infection (otitis media) develop quickly and resolve in a few days. This is known as acute otitis media.

The main symptoms of acute otitis media include:

In some cases, a hole may develop in the eardrum (perforated eardrum) and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

Although it's less common than acute otitis media, some children have a persistent and painless discharge from their ear that lasts for many months as a result of an ear infection. This is known as chronic suppurative otitis media (CSOM). 

Symptoms in babies

As babies are unable to communicate the source of their discomfort, it can be difficult to tell what is wrong with them. Signs your baby may have an ear infection include:

  • pulling, tugging or rubbing their ear
  • irritability
  • poor feeding
  • restlessness at night
  • coughing 
  • a runny nose
  • diarrhoea
  • unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness
  • loss of balance

When to seek medical advice

As most cases of otitis media pass within a few days, there's usually no need to see your GP.

However, you should take your child to see a GP if their symptoms show no sign of improvement after two or three days, they seem to be in a lot of pain, or you notice a discharge of pus or fluid from their ear.

You should also contact your GP if your child has an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make them more vulnerable to complications.

Glossary

Acute
Acute means occurring suddenly or over a short period of time.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Fever
A high temperature, also known as a fever, is when someone's body temperature rises above the normal 37°C (98.6°F).
Vomiting
Vomiting is when you bring up the contents of your stomach through your mouth.
Chronic
Chronic usually means a condition that continues for a long time or keeps coming back.

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