Ear infections in adults (middle ear): Causes, symptoms, and treatment Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe Why do adults get ear infections Medically reviewed by Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP — By Jon Johnson — Updated on July 17, 2022Ear infections are not as common in adults as in children, although they can be more serious. Certain situations and actions put some people more at risk for ear infections than others. However, several useful steps can help toward prevention and treatment. Learn more about them in this article. Symptoms Share on PinterestChalabala/Getty ImagesThe ear is a complicated part of the body, consisting of several different parts. Ear infections can strike in any of these parts and cause various symptoms. The three main parts of the ear are the inner, middle, and outer ear. Symptoms of ear infections in adults vary depending on location and can include:inflammation and paintenderness to the touchhearing changesnauseavomitingdizzinessfeverheadacheswelling of the ear Discharge from the ear can signify a more serious issue, such as an eardrum rupture, and requires medical attention. Middle ear infections The middle ear is the area directly behind the eardrum. Middle ear infections, also known as otitis media, are typically due to bacteria or viruses from the mouth, eyes, and nasal passages. A middle ear infection may have the following symptoms:pain and a feeling of plugged earssome people may have trouble hearing, as an inflamed eardrum is not as sensitive to sound as it needs to bea buildup of fluid or pus behind the eardrum, which can make hearing more difficult and may feel as if the affected ear is underwater.if the eardrum tears or bursts due to the build of pressure from the infection, fluid may drain from the earfever and general tiredness Outer ear infections The outer ear extends from the ear canal on the outside of the eardrum to the outer opening of the ear itself. Outer ear infections can also result from irritation or injury to the ear canal from foreign objects, such as cotton swabs or fingernails and water exposure. People may refer to outer ear infections as otitis externa. Common symptoms include an ear or ear canal that is painful, swollen, and tender to the touch. The skin may become red and warm until the infection goes away. Causes and risk factors Ear infections in adults are typically due to germs, such as viruses, fungus, or bacteria. In rare cases, people with weakened immune systems or inflammation in the structures of the ear may be more prone to ear infections than others. For example, diabetes is a risk factor for malignant otitis externa, a rare condition involving infection of the bones in the ear canal. People with chronic skin conditions, including eczema or psoriasis, may also be prone to outer ear infections. Middle ear infections The common cold, flu, and allergies can lead to middle ear infections. Other upper respiratory problems, such as sinus or throat infections, can lead to middle ear infections as the bacteria make their way into the eustachian tubes. The eustachian tubes connect from the ear to the nose and throat and are responsible for controlling the pressure in the ear. Their position makes them easy targets for germs. Infected eustachian tubes can swell and prevent proper drainage, which works toward the symptoms of middle ear infections. People who smoke or are around smoke may also be more likely to get middle ear infections. Types of middle ear infections include:Acute otitis media: This type usually occurs suddenly after a cold or infection. It primarily affects children ages 6 to 24 months but can also occur in adults.Otitis media with effusion: Fluid stays in the middle ear after the infection clears up, affecting the hearing and causing a feeling of fullness in the ear. It is more common in children but can also occur in adults.Chronic suppurative otitis media: These are repeat infections often from a ruptured or perforated eardrum, which can result in discharge and hearing impairment. Outer ear infections One common outer ear infection is known as swimmer’s ear. People who spend a lot of time in water may be more at risk of developing this infection. Water that sits in the ear canal after swimming or bathing creates a perfect place for bacteria or fungus to multiply. For this reason, untreated water may be more likely to cause an outer ear infection. Ear infections in older adults While ear infections are more common in children, older adults can also get them. Swimmer’s ear is most common in people ages 45 to 75. A potentially life threatening ear infection, malignant otitis externa, mostly occurs in older people with diabetes or weakened immune systems. The aging process may affect the structure of the ears, making older adults more susceptible to ear diseases. A 2017 Northern Saudi Arabia study of 138 people ages 60 and over found that 9.4% had a middle ear infection. Older adults who have ear infections may experience symptoms such as the following:balance problemsvertigohearing loss Ear tubes To treat chronic ear infections, a doctor may surgically insert a tiny tube made of plastic or metal into the ear drum. This tube connects the middle ear to the outer ear. The tube allows air to flow in and out of the middle ear if mucus or inflammation prevents ventilation. This stops fluid from building up in the middle ear, leading to an infection. There are two types of ear tubes. Short-term ear tubes last 6 months to 2 years before falling out on their own. Long-term tubes are often larger and have rims, feet, or flanges to hold them in place. These may fall out independently or may require surgical removal. Ear tubes as a treatment are most common for children ages 1-3 years. It is the most common childhood surgery performed under anesthesia. When to contact a doctor In many cases, ear infections can go away on their own, so a minor earache may not be a worry. A doctor will typically see if symptoms do not improve within 3 days. If new symptoms occur, such as a fever or loss of balance, a person should see a doctor immediately. Any sign of discharge coming from the ear also requires a visit to a doctor. Diagnosis Doctors need to know a person’s medical history for an accurate diagnosis. They will ask about any symptoms, as well as any medications that a person takes. The doctor will use an otoscope to look at the eardrum and ear canal for signs of infection. Doctors may also use a tympanometer to blow puffs of air onto the eardrum. They will then check how it reacts, which can help diagnose a middle ear infection. Treatment Depending on the cause, some ear infections clear up without treatment. However, doctors may recommend other treatments to speed up the healing process. Antibiotics and other prescriptions According to the Centers for Disease Control and Prevention (CDC), using antibiotics by mouth to treat ear infections may not help certain cases of middle ear infections. Antibiotics are not effective against outer ear and viral infections. The main treatments for outer ear infections are manual cleanings and ear drops. The type of ear drop will depend on what is causing the infection. In the case of malignant otitis externa, intravenous antibiotics are the primary treatment. Over-the-counter medications Drugs, including acetaminophen (Tylenol) and ibuprofen (Advil), help many adults with ear infections treat the pain associated with the accompanying inflammation. Decongestants or antihistamines, such as pseudoephedrine (Sudafed) or diphenhydramine (Benadryl), may also help relieve some symptoms, especially those caused by excess mucus in the eustachian tubes. Nonprescription ear drops may help treat mild cases of swimmer’s ear. According to ear specialists, a person can make a simple at-home blend by mixing half rubbing alcohol and half white vinegar. A few drops in the ears can help dry out the ear canal and support the healing process. People with ear tubes, permanent injuries to their eardrums, or certain ear surgeries should not use ear drops. If someone experiences ear discharge, they should stop using ear drops and seek medical attention. Prevention Some simple every day steps and lifestyle choices help prevent many ear infections. Some basic hygiene tips and lifestyle choices will also support prevention.quitting smoking can help reduce respiratory and ear infectionscleaning and drying ears after swimmingrefraining from cotton swab usepracticing regular handwashing and overall hygiene Outlook If a person suspects they have an ear infection, they should always seek medical assistance. People with a history of recurrent ear infections should visit an ear specialist. A doctor’s guidance can help someone relieve their symptoms, treat the infection, and take steps to prevent the infection from reoccurring. In rare instances, ear infections in adults can lead to serious consequences, including hearing loss. Summary Although ear infections occur most commonly in children, adults may get them as well, and they may be more serious. People with diabetes or chronic skin conditions such as eczema or psoriasis may be more prone to them. Ear infections usually occur in the middle ear and outer ear. They may be the result of viruses, bacteria, or a fungus. The symptoms of an ear infection may include pain, tenderness, and hearing changes. Older adults may also experience balance problems and vertigo. Since an ear infection in adults can lead to serious health issues, it is important to see a doctor for treatment. Read the article in Spanish. Last medically reviewed on July 17, 2022Public HealthEar, Nose, and ThroatInfectious Diseases / Bacteria / Viruses 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Alenezi, N. G., et al. (2017). Ear diseases and factors associated with ear infections among the elderly attending hospital in Arar City, Northern Saudi Arabia.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633230/Balance problems and disorders. (2017). https://www.nia.nih.gov/health/balance-problems-and-disordersDanishyar, A., et al. (2022). Acute otitis media.https://www.ncbi.nlm.nih.gov/books/NBK470332/Ear infection. (2021).https://www.cdc.gov/antibiotic-use/ear-infection.htmlEar tubes. (n.d.).https://www.enthealth.org/be_ent_smart/ear-tubes/Hearing loss: a common problem for older adults. (2018).https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adultsPreventing and treating ear infections. (n.d.)https://www.cdc.gov/antibiotic-use/pdfs/EAR-INFECTION-H.pdfSearight, F. T., et al. (2022). Otitis media with effusion.https://www.ncbi.nlm.nih.gov/books/NBK538293/Spaw, M., et al. (2022). Tympanostomy tube.https://www.ncbi.nlm.nih.gov/books/NBK565858/Swimmer's ear (otitis externa). (n.d.).https://www.enthealth.org/conditions/swimmers-ear-otitis-externa/Wiegand, S., et al. (2019). Otitis externa.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522672/FEEDBACK:Medically reviewed by Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP — By Jon Johnson — Updated on July 17, 2022 Latest newsWhat sets 'SuperAgers' apart? 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