A severe ear infection is a painful condition that can affect the outer, middle, or inner ear, or in some cases all three areas. Most infections are bacterial in nature, though a virus that causes the flu, mumps, chickenpox, or a respiratory cold can also cause ear problems. Local symptoms can vary, but they usually include throbbing pain, hearing difficulties, and fluid discharge. Body-wide symptoms such as chills and nausea are also common with a severe ear infection. Most infections can be treated with antibiotics or antiviral drugs, but clinical cleaning procedures or surgical intervention may be necessary.
Severe ear infections are most commonly seen in children, partially due to their immature immune systems and poorer hygiene practices. Outer ear infections are usually bacterial and can be caused by improper cleaning, scrapes, sticking an object in the ear, or swimming in dirty water. The outer ear canal may be itchy, bright red, and painful. A yellowish pus may develop and drain from the ear as the infection worsens.
Middle ear infections arise from blockages in the Eustachian tubes that run from the ear to the back of the throat. Common viruses and allergies can cause inflammation in the tubes, causing them to constrict. As fluid backs up, bacteria and other pathogens begin to build up in the Eustachian tubes and cause further irritation. The ear may feel full and hearing can be diminished. A severe ear infection in the middle ear is often accompanied by diarrhea, nausea, vomiting, fever, and other flu-like symptoms.
In general, viral and bacterial infections of the inner ear cause the most severe symptoms and have the highest risk of complications. Most cases arise alongside upper respiratory tract infections. The innermost part of the ear, called the labyrinth, houses structures that are essential to hearing and maintaining balance. Any bacteria or virus that penetrates the membranes surrounding the labyrinth can cause serious hearing difficulties, mental confusion, and vertigo. A person with a severe ear infection may be extremely fatigued and unable to stand or walk without feeling nauseous and vomiting.
A child who shows signs of a severe ear infection should be brought to a pediatrician for a thorough evaluation. The doctor can inspect the external and middle ear to look for signs of infection. In the case of inner ear problems, computerized tomography scans are commonly used to check for major damage to nerves, blood vessels, and bones in the area. Samples of blood, fluid, or pus are analyzed to identify the pathogen responsible for symptoms. Hearing and balance tests are also performed to gauge the severity of the problem.
The doctor may decide to manually clean the patient's ear in his or her office to remove existing bacteria. Oral antibiotics and medicated ear drops are usually enough to clear up an outer, middle, or inner ear infection. If problems are caused by a virus, other drugs may be prescribed as well. Surgery is only necessary when the eardrum, cochlea, or Eustachian tube has been damaged by infection.