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How Ear Infections Develop

by Jerome O. Klein, M.D.
reviewed by Lynn Cates, M.D., F.A.A.P. and Laura Jana, M.D., F.A.A.P.
You probably have noticed that your child often has a cold before she complains of an earache, and you may wonder how colds and ear infections are related. Over the years, investigators have identified a sequence of events that unfolds as an acute middle ear infection develops. The progression is as follows:

  1. An upper respiratory tract infection, usually a cold, results in congestion and inflammation of the mucous membranes (or mucosa) of the nose, throat, eustachian tube, and middle ear.
  2. Congestion of the mucosa in the eustachian tube leads to obstruction in the narrowest portion of the tube (connecting the two horns).

  3. This obstruction of the eustachian tube causes negative pressure to develop in the middle ear.

  4. The negative pressure and inflammation leads to the middle ear's filling with fluid.

  5. Bacteria and/or viruses are constantly drifting in and out of the middle ear. They originate in the nose and get to the middle ear through the eustachian tube. When the eustachian tube is blocked, bacteria get trapped in the middle ear because they cannot be expelled to travel back to the nose.
  6. Bacteria trapped in the middle ear fluid multiply, causing infection and increased fluid production.

  7. The bacterial and/or viral infection of the middle ear fluid results in further inflammation and causes the symptoms of acute otitis media, such as earache, fever, decreased hearing, or drainage of pus from the ear.

 RELATED INFORMATION
*  Diagnosing Ear Infections
*  What To Expect With Treatment For Ear Infections
*  Ear Infections
*  Nose and Sinus Problems


Created January 19, 2001
Reviewed January 23, 2001
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