Why do adults get ear infections?

Ear infections in adults are typically due to germs, such as viruses, fungus, or bacteria.

In rare cases, people with weakened immune systems or inflammation in the structures of the ear may be more prone to ear infections than others. For example, diabetes is a risk factor for malignant otitis externa, a rare condition involving infection of the bones in the ear canal.

People with chronic skin conditions, including eczema or psoriasis, may also be prone to outer ear infections.

Middle ear infections

The common cold, flu, and allergies can lead to middle ear infections. Other upper respiratory problems, such as sinus or throat infections, can lead to middle ear infections as the bacteria make their way into the eustachian tubes.

The eustachian tubes connect from the ear to the nose and throat and are responsible for controlling the pressure in the ear. Their position makes them easy targets for germs.

Infected eustachian tubes can swell and prevent proper drainage, which works toward the symptoms of middle ear infections.

People who smoke or are around smoke may also be more likely to get middle ear infections.

Types of middle ear infections include:

  • Acute otitis media: This type usually occurs suddenly after a cold or infection. It primarily affects children ages 6 to 24 months but can also occur in adults.
  • Otitis media with effusion: Fluid stays in the middle ear after the infection clears up, affecting the hearing and causing a feeling of fullness in the ear. It is more common in children but can also occur in adults.
  • Chronic suppurative otitis media: These are repeat infections often from a ruptured or perforated eardrum, which can result in discharge and hearing impairment.

Outer ear infections

One common outer ear infection is known as swimmer’s ear. People who spend a lot of time in water may be more at risk of developing this infection.

Water that sits in the ear canal after swimming or bathing creates a perfect place for bacteria or fungus to multiply. For this reason, untreated water may be more likely to cause an outer ear infection.

Ear infections in older adults

While ear infections are more common in children, older adults can also get them.

Swimmer’s ear is most common in people ages 45 to 75. A potentially life threatening ear infection, malignant otitis externa, mostly occurs in older people with diabetes or weakened immune systems.

The aging process may affect the structure of the ears, making older adults more susceptible to ear diseases.

A 2017 Northern Saudi Arabia study of 138 people ages 60 and over found that 9.4% had a middle ear infection.

Older adults who have ear infections may experience symptoms such as the following:

  • balance problems
  • vertigo
  • hearing loss

Ear tubes

To treat chronic ear infections, a doctor may surgically insert a tiny tube made of plastic or metal into the ear drum. This tube connects the middle ear to the outer ear.

The tube allows air to flow in and out of the middle ear if mucus or inflammation prevents ventilation. This stops fluid from building up in the middle ear, leading to an infection.

There are two types of ear tubes.

Short-term ear tubes last 6 months to 2 years before falling out on their own. Long-term tubes are often larger and have rims, feet, or flanges to hold them in place. These may fall out independently or may require surgical removal.

Ear tubes as a treatment are most common for children ages 1-3 years. It is the most common childhood surgery performed under anesthesia.

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