What happens if a middle ear infection is not treated?

A middle ear infection develops behind the eardrum, often after a cold or when nasal inflammation affects drainage. Some infections settle with observation, while others need treatment based on age, symptoms, examination and cause. Ongoing fluid can make sounds seem distant and may affect speech, learning or balance, particularly in a child.

Persistent infection can lead to a perforated eardrum, discharge, worsening pain or fever. Rarely, infection can extend to nearby bone or deeper tissues. Allergic Rhinitis and a Common Cold can contribute to blocked drainage, but ear symptoms still need an examination when they persist.

Arrange a GP Consultation if earache, fever, reduced hearing or irritability continues, returns, or affects sleep. A clinician can examine the eardrum and decide whether observation, pain relief, antibiotics or follow-up is appropriate. Keep the ear dry if there is discharge, and do not insert cotton buds, oil or drops unless advised.

For a child, note drinking, sleep, responsiveness and hearing. Record when symptoms started and whether there has been Ear Discharge or a recent cold.

Seek urgent care for swelling or redness behind the ear, the ear pushed outward, severe worsening pain, marked drowsiness, repeated vomiting, new facial weakness, severe dizziness, or a child who is difficult to wake or not drinking.

Ask: Is the eardrum infected or is fluid trapped behind it? Is hearing affected? Does this need antibiotics or monitoring? How should pain and fever be managed? When should discharge, hearing loss or Vertigo be reviewed?