An ear infection, medically known as otitis media, is an inflammation of the air-filled space behind the eardrum (the middle ear). These infections, often caused by bacteria or viruses, are common in both children and adults, typically following a cold or respiratory illness that causes swelling of the eustachian tubes. The resulting blockage traps fluid in the middle ear, where it can become infected, leading to symptoms like ear pain, a feeling of fullness, and fever. While mild infections may resolve without intervention, allowing persistent symptoms to go unaddressed risks serious complications that can permanently affect hearing and overall health.
Worsening Local Symptoms and Damage
Ignoring an active middle ear infection allows the infectious process to continue, leading to increased discomfort and structural damage. The trapped fluid and pus create pressure against the tympanic membrane (eardrum), intensifying ear pain. This pressure buildup also causes temporary hearing loss because the eardrum cannot vibrate correctly to transmit sound. If the pressure becomes too great, it can lead to a spontaneous rupture or perforation of the eardrum. While a small tear usually heals on its own, the perforation provides an opening for external bacteria to enter the middle ear space, raising the risk of future or chronic infections.
The Threat of Chronic Issues
Failure to treat an ear infection can transition an acute problem into a chronic condition, especially if fluid persists in the middle ear for an extended time (otitis media with effusion). Chronic fluid accumulation and inflammation commonly cause conductive hearing loss because the eardrum and tiny middle ear bones (ossicles) cannot transmit sound vibrations efficiently. If repeated infections cause permanent damage or scarring to these structures, the hearing loss can become irreversible. A chronic infection can also lead to the development of a cholesteatoma, an abnormal skin growth that develops in the middle ear or mastoid bone. This growth, composed of trapped skin cells and debris, slowly erodes surrounding bone structures and requires surgical removal, potentially causing significant hearing loss, dizziness, or facial nerve weakness.
Spread of Infection Beyond the Ear
The most severe consequence of ignoring an ear infection is the spread of the bacterial infection beyond the middle ear space. The closest structure is the mastoid bone, the bony prominence behind the ear that contains air-filled spaces. If the infection spreads here, it causes mastoiditis, involving inflammation and destruction of the mastoid bone. Mastoiditis presents with pain, swelling, and redness behind the ear, requiring aggressive treatment, often with intravenous antibiotics and sometimes surgery. In rare cases, the infection can pass through the bone and spread to the central nervous system, resulting in intracranial complications.
Intracranial Complications
These complications include meningitis, an infection of the protective membranes surrounding the brain and spinal cord. Untreated ear infections are a known cause of meningitis, which can be life-threatening and may lead to long-term neurological problems. Another potential complication is a brain abscess, a localized collection of pus within the brain tissue.
Other Severe Complications
Other potential issues include labyrinthitis, an inner ear infection that causes severe dizziness and balance issues, and facial nerve paralysis, resulting from swelling or erosion affecting the nerve that controls facial muscles. While the likelihood of these severe outcomes is low due to modern antibiotics, they remain a possibility when symptoms are ignored.
When to Seek Immediate Medical Help
While some mild ear infections may resolve naturally, certain symptoms indicate a need for immediate medical evaluation. Seek prompt attention if ear pain is severe, does not improve with over-the-counter medication, or lasts longer than two to three days. A fever of 102.2°F (39°C) or higher, especially in infants, warrants a visit to a healthcare provider. Any fluid, pus, or bloody discharge draining from the ear should be checked by a doctor, as this may signal a perforation or chronic infection. Urgent care is necessary if you notice swelling, redness, or tenderness behind the ear (indicating mastoiditis), or if symptoms suggest the infection has spread, such as a stiff neck, severe headache, or confusion.