Otitis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Otitis?
Ear infections are often first seen by a primary care doctor or a pediatrician (a children's doctor). An otolaryngologist (an ear, nose, and throat doctor) treats infections that keep coming back or need surgery. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is otitis?
An ear infection usually affects the middle ear and is called otitis media. It is an inflammation of the middle ear, usually caused by bacteria. It occurs when fluid builds up behind the eardrum. Ear infections are the most common reason parents bring their child to a doctor.
Swimmer's ear, called otitis externa, is inflammation, irritation, or infection of the outer ear and ear canal.
Symptoms
A middle ear infection causes pain in the ear, commonly called an earache, and your child might also have a fever. Many children are too young to say that their ear hurts, so look for these signs:
- Tugging or pulling at the ears.
- Fussiness and crying.
- Trouble sleeping.
- Fluid draining from the ear.
- Clumsiness or problems with balance.
- Trouble hearing or responding to quiet sounds.
Swimmer's ear can cause drainage from the ear that is yellow, yellow-green, pus-like, or foul smelling. It can also cause ear pain that gets worse when you pull on the outer ear, hearing loss, and itching.
Causes and who gets it
An ear infection is usually caused by bacteria and often begins after a sore throat, cold, or other upper respiratory infection. The eustachian tube is a small passageway that connects the upper part of the throat to the middle ear. In children, these tubes are smaller and more level than in adults, which makes it harder for fluid to drain. A child's immune system is still developing, so it is harder for children to fight infections. Babies who are around smokers have more ear infections.
Swimming in unclean water can lead to swimmer's ear. Scratching the ear, getting something stuck in the ear, or cleaning wax with cotton swabs or small objects can damage the skin of the ear canal.
How doctors diagnose it
For a middle ear infection, the doctor first asks about your child's health. The simplest way to tell is to use a lighted instrument, called an otoscope, to look at the eardrum. If the diagnosis is still unclear, a doctor might use tympanometry, a test that uses sound tones and air pressure. For swimmer's ear, the provider looks inside the ear, where the ear canal looks red and swollen. A sample of fluid may be sent to a lab to look for bacteria or fungus.
Treatment
Often, ear infections go away on their own. A provider may recommend pain relievers, and severe infections and infections in young babies may need antibiotics. If the diagnosis is not clear and the child has no severe ear pain or fever, the doctor might wait a day or two to see if the earache goes away. If a doctor prescribes an antibiotic, give it exactly as prescribed for the full time. Stopping too soon could let the infection come back. A child who has a fever or flu-like symptoms should not be given aspirin unless a doctor says so. If infections keep coming back, many doctors recommend a surgery that places a small tube in the eardrum to improve air flow and prevent fluid backup.
For swimmer's ear, most people need antibiotic ear drops.
When to see a doctor
If it has been several days and your child still seems sick, call your doctor. Contact your provider for any symptoms of swimmer's ear, drainage from the ears, or symptoms that get worse or continue despite treatment. In older people and people with diabetes or a weak immune system, a swimmer's ear infection may become severe. Call 911 or go to the emergency room for fever with pain and redness behind the ear. Go for fever with a stiff neck, confusion, or trouble waking up too.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can look in the ear, treat common infections, and refer you to an ear, nose, and throat doctor if infections keep coming back.
Common questions
Do ear infections go away on their own?
Often, yes. A child should start feeling better within a few days after visiting the doctor.
Can an ear infection affect hearing?
Yes, it can, because sound cannot get through the fluid in the middle ear. After the infection clears, fluid may still remain in the middle ear but usually disappears within three to six weeks.
Is swimmer's ear the same as a middle ear infection?
No, swimmer's ear affects the outer ear and ear canal. A middle ear infection is an inflammation of the middle ear that occurs when fluid builds up behind the eardrum.
Can ear infections be prevented?
Yes, you can lower the risk. The best way to prevent ear infections is to reduce the risk factors associated with them. Make sure your child gets the flu vaccine every year and wash hands often. To help prevent swimmer's ear, dry your ears very well after they get wet.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
