Chronic Middle Ear Infection in Children

Reviewed/Revised Jun 2024
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What is a chronic middle ear infection?

The middle ear is the space just behind the eardrum. Germs can get in the middle ear and cause an infection. A middle ear infection is also called otitis media. A chronic infection is one that lasts a long time (even with treatment) or keeps coming back.

  • Chronic ear infections can permanently damage parts of the ear that help your child hear

  • They usually don’t cause pain

What causes chronic ear infections?

A chronic ear infection is more likely if your child has:

  • Lots of acute ear infections

  • A hole in the eardrum (for example from an injury or ear surgery), particularly if water gets in the ear

  • A blocked eustachian tube (the tube connecting the inside of the ear to the back of the throat)

  • Certain birth defects, such as a cleft palate, that affect the mouth and face

  • Down syndrome

Chronic ear infections may get worse (flare up) after your child has a cold or other nose or throat infection.

What are the symptoms of a chronic ear infection?

  • Trouble hearing

  • Pus or liquid coming out of the ear—the pus may smell very bad

Chronic ear infections shouldn't hurt unless the infection has spread to the bone next to the ear. Tell your doctor if your child has a chronic ear infection and starts to have pain.

How can doctors tell if my child has a chronic ear infection?

  • Doctors will look in your child's ear to see if pus is draining out of a hole in the eardrum

  • They’ll also look for any abnormalities in the eardrum

If doctors think the infection might have spread, they'll do a CT (computed tomography) scan or MRI (magnetic resonance imaging).

How is a chronic ear infection treated?

Doctors will:

  • Clean out your child’s ear

  • Have you put antibiotic and corticosteroid ear drops in your child’s ear

  • Have you keep water from getting in your child's ear

If the infection is very bad, doctors will also give your child antibiotics to take by mouth.

If your child's eardrum is damaged or has an abnormal growth on it, doctors will often do surgery.

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