An ear infection, or otitis media, occurs when the middle ear becomes inflamed, often due to bacterial or viral presence. A “double” ear infection means it affects both ears simultaneously. This condition often results from a common cold or other upper respiratory infection and is particularly common in young children.
Key Signs and Symptoms
Observing a double ear infection in an infant or toddler involves changes in their behavior and physical cues. Young children might pull or tug at both ears, display increased irritability, and cry more frequently. They may also experience difficulty sleeping or feeding, as pressure changes from sucking or lying down can intensify ear pain. A fever, often 100.4°F (38°C) or higher, is a common accompanying symptom.
Older children and adults can verbalize their discomfort, reporting ear pain ranging from a dull ache to a sharp, throbbing sensation in both ears. They might describe a feeling of fullness or pressure, or a temporary reduction in hearing. This hearing change can manifest as muffled sounds or difficulty understanding speech, particularly in noisy environments. Fluid may drain from one or both ears, appearing as a yellowish, brownish, or bloody discharge. This discharge often indicates a small tear in the eardrum, which usually heals.
Why a Double Ear Infection Occurs
Double ear infections develop because the anatomy of the Eustachian tubes, which connect the middle ear to the back of the throat, allows for easy spread of infection. In children, these tubes are narrower, more horizontal, and shorter than in adults, making them more prone to fluid accumulation and blockage. When a child has an upper respiratory infection, such as a cold or the flu, inflammation can cause the Eustachian tubes to swell and become blocked. This blockage prevents air from entering the middle ear and fluid from draining, creating a warm, moist environment where viruses or bacteria can multiply.
Common pathogens responsible for these infections include various cold viruses, as well as bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. Allergies can also contribute to Eustachian tube inflammation, increasing the risk of fluid buildup and subsequent infection. The presence of infection in one ear can predispose the other ear to infection due to widespread inflammation in the nasal passages and throat connecting to both Eustachian tubes. Therefore, a bilateral infection often stems from a systemic response to a viral or bacterial agent.
What to Expect During Diagnosis
A healthcare professional will use an otoscope, a handheld instrument with a light and magnifying lens, to examine the eardrums. During this examination, the doctor will observe the color, position, and movement of each eardrum. A healthy eardrum appears pearly gray and translucent, with visible landmarks. In contrast, an infected eardrum may appear red, bulging outward, or dull and opaque, indicating fluid accumulation behind it.
The doctor may also perform pneumatic otoscopy, which involves puffing air into the ear canal through the otoscope. This test assesses the eardrum’s mobility; a healthy eardrum will move freely with the air puff. If fluid is present, the eardrum’s movement will be restricted or absent. By examining both ears, the healthcare provider can confirm a double ear infection and assess its severity.