What are the first signs of middle ear infection?

A middle ear infection develops behind the eardrum, often after a cold has caused congestion. Young children may tug at the ear, cry more than usual, wake frequently, or have difficulty feeding because swallowing changes pressure in the ear. Older children and adults can describe blocked hearing, pressure, or pain. Fluid or discharge from the ear can occur if the eardrum becomes damaged. Vertigo is less typical and deserves clinical advice.

Arrange a GP consultation when ear pain is persistent, hearing is reduced, symptoms are worsening, or a child is distressed. Keep the ear dry and do not put cotton buds, oil, or unprescribed drops into it. Offer fluids and use age-appropriate pain relief only as directed on the product label or by a clinician. Antibiotics are not needed for every ear infection; the decision depends on the examination and the person’s symptoms.

Seek urgent medical advice for swelling or severe tenderness behind the ear, new facial weakness, severe dizziness, repeated vomiting, marked drowsiness, or a child who appears seriously unwell. Prompt assessment is also sensible when ear discharge is bloody, pain is severe, hearing changes suddenly, or fever persists. A clinician can look at the eardrum and distinguish middle ear infection from problems in the ear canal or nearby structures.

Ask whether the eardrum shows infection or trapped fluid, how to manage pain, and what changes would mean the infection needs review. If antibiotics are suggested, ask how to take them and when improvement should be checked.