What Causes Ear Infections

By , May 16th, 2013 | Infant Care, Toddler Care | 1 Comment

Chelsea Wicks, MD, pediatrician, Renown Medical Group

What causes ear infections

One of the most common reasons for pediatric office visits is otitis media, more commonly called a middle ear infection.

I have had many parents with concerns that water getting into their child’s ear may have caused an ear infection. Though children can get otitis externa, or outer ear infection (also commonly called swimmer’s ear) from water getting caught in the ear canal, water will not cause a true “ear infection.”  Many people have misconceptions of the cause of true ear infections.

Actually, bacterial middle ear infections are caused by fluid BEHIND the ear drum getting infected. Typically mucous builds up in the sinuses from a common cold or upper respiratory infection and then gets caught in the eustachian tube (a canal that connects the middle and inner ear to the sinuses). That fluid then can become stagnant and gets secondarily infected by bacteria.

Smaller children, between the ages of six months and two years, are more at risk for this because their eustachian tubes tend to be smaller and more flat so it is harder for the fluid to drain out.  Ear infections can also be caused by viruses. In fact, recent research has shown that the majority of ear infections are probably due to viruses rather than bacteria.

In the past, physicians would actually tap the ear drum to drain the fluid and then could test for the cause of infection. That is no longer a standard of care so now we rely on symptoms and physical exam to best determine if antibiotics are warranted. Typically, if the child has fever, ear pain and is noted to have purulent fluid behind the ear drum on exam, it is likely a bacterial infection and would be best treated with antibiotics.

If you are concerned your child might have an ear infection you can look up more signs and symptoms in the Renown Health Kids Health Library. If you suspect your child has an ear infection be sure to consult with your child’s primary care physician. To find a doc visit

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