When to worry about earache with a middle ear infection

Infection behind the eardrum can cause pressure, inflammation, and throbbing pain. A blocked sensation and reduced hearing may occur as fluid collects. If the eardrum opens, pain may change while fluid drains; that change does not prove the infection has cleared, so an examination can still be needed.

Use suitable pain relief according to the product instructions or a clinician's guidance. Rest and drink fluids. Keep the ear dry, wipe only the outer ear if fluid appears, and do not insert objects or use leftover drops. If antibiotics or other treatment were prescribed, follow the directions and report worsening symptoms.

Contact a clinician promptly for persistent or increasing pain, ear discharge, new hearing loss, or fever that does not settle. Seek urgent help for swelling or tenderness behind the ear, severe dizziness, repeated vomiting, facial weakness, confusion, a stiff neck, or a child who is unusually sleepy or difficult to wake.

Ask whether fluid is trapped behind the eardrum, whether the eardrum is intact, and how improvement will be judged. Tell the clinician when pain began, whether it is one-sided, any discharge or hearing change, the temperature, and medicines already taken.