Middle ear infection (otitis media) - Symptoms 

Symptoms of middle ear infection 

In most cases the symptoms of an ear infection (otitis media) develop quickly and resolve in a few days – often referred to as acute otitis media.

Main symptoms of acute otitis media include:

  • earache
  • a high temperature (fever) of 38°C (100.4°F) or higher
  • being sick
  • lack of energy
  • slight deafness

Babies with ear infections will be hot and irritable. As babies are unable to communicate the source of their discomfort, it can be difficult to tell what is wrong with them. However, your baby may have an ear infection if they are unsettled in this way.

Other signs to look for in younger children 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 sitting too close to the television or inattentiveness
  • loss of balance

Sometimes, in cases of middle ear infection, the eardrum will become perforated (a hole will form in it) and pus may run out of the ear. This can help to relieve the pain by releasing the pressure on the eardrum, but it may also lead to re-infection.

When to seek medical advice

Speak to your GP if your child’s symptoms show no sign of improvement after 24 hours, they seem to be in a lot of pain, or you notice a discharge of  pus or fluid from their ear.

Long term ear infection 

Ear infections that last for many months are known as chronic suppurative otitis media (CSOM). This condition is less common, affecting around 1 in 100 children and 1 in 50 adults.

The most common symptom of CSOM is a persistent and usually painless drainage from the affected ear.

Some degree of hearing loss in the affected ear is also common.


Page last reviewed: 23/04/2012

Next review due: 23/04/2014

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A reoccurring condition

Otitis media usually reoccurs several times during childhood years.

One third of children will have six or more episodes of otitis media by the time they are seven years old.

The condition occurs less often as the child gets older.

It would be unusual for children over the age of seven to be affected by further episodes of otitis media