Ear Infections

Symptoms

• Ear pain: An aching, throbbing, or sharp pain in the ear, often worse when lying down.
• Muffled or reduced hearing: Fluid behind the eardrum can make sounds seem dull or distant.
• Ear drainage: Clear, yellow, or bloody fluid draining from the ear can mean the eardrum has ruptured, which often relieves the pain.
• Feeling of fullness or pressure: A sense that the ear is plugged or blocked.
• Fever: A mild to moderate fever is common, especially in children.
• Trouble sleeping: Pain and pressure often worsen when lying flat, disrupting sleep.
• Fussiness in young children: Infants may tug at the ear, cry more, sleep poorly, or feed less.
• Balance changes or dizziness: Middle ear infections can occasionally affect balance.
• Itching, redness, or pain with tugging the outer ear: Suggests swimmer's ear, an infection of the ear canal.

When It's an Emergency

Come straight to Bellaire ER — open 24/7 — if you or your child have signs that the infection may be spreading or causing a serious complication: redness, swelling, or tenderness of the bony area behind the ear that pushes the ear outward or forward. This can be a sign of mastoiditis, a serious infection that needs urgent treatment.

Seek emergency care for a very high fever (especially over 104°F, or any fever in an infant under 3 months), a stiff neck, severe headache, confusion, drowsiness that is hard to rouse, or severe swelling of the face or neck. These can point to a spreading infection.

Go to the ER for sudden hearing loss, severe or rapidly worsening ear pain, facial weakness or drooping on the side of the infection, or new dizziness with vomiting. Also seek prompt care if ear pain follows a head injury or a suspected object or insect in the ear canal.

When in doubt with a young child who seems very sick, listless, or is not drinking fluids, it is safer to be evaluated in person; Bellaire ER can rule out serious complications on-site at any hour.

When It's Not an Emergency

Most ear infections are not emergencies. Many ear infections, particularly mild middle-ear infections in older children and adults, improve on their own within a few days with rest, fluids, and over-the-counter pain relievers such as acetaminophen or ibuprofen.

Telemedicine or online urgent care is often a reasonable first step for typical ear pain without red-flag symptoms. A clinician can review your symptoms, advise on pain control, and prescribe antibiotics when appropriate, such as for swimmer's ear or a clear middle-ear infection.

An in-person urgent care visit or your primary doctor is a good option when a clinician needs to look inside the ear, when symptoms last more than a couple of days, or for recurring infections. Reserve the ER for the red flags above or when you cannot safely wait.

What Happens at Bellaire ER

At Bellaire ER, a board-certified emergency physician examines the ear with an otoscope to look at the ear canal and eardrum and check for fluid, redness, or a ruptured eardrum.

If a more serious problem is a concern, we can use on-site CT imaging and full laboratory testing to look for signs of a spreading infection such as mastoiditis. Because our diagnostics are on-site, we can evaluate, diagnose, and start treatment in a single visit.

Treatment is matched to the diagnosis and may include prescription or antibiotic ear drops, oral antibiotics, and pain control. Most patients are treated and discharged the same visit without needing a hospital transfer, with clear instructions on follow-up and warning signs to watch for.

Prevention

You can lower the risk of some ear infections. Keeping ears dry and using well-fitting earplugs or drying drops after swimming helps prevent swimmer's ear; avoid inserting cotton swabs, which can scratch the canal.

Not smoking and avoiding secondhand smoke, managing allergies and nasal congestion, and staying current on recommended vaccines can reduce middle-ear infections, particularly in children. For infants, breastfeeding and avoiding bottle-feeding while lying flat may lower the risk.