Acute Otitis Media in Adults

Overview

Acute otitis media (AOM) is an infection of the middle ear, often triggered by a cold, sinus infection, or seasonal allergies. While most common in children, AOM can also affect adults, and though it usually resolves with antibiotics, it can occasionally lead to serious complications.

Symptoms in adults include:

• Sudden ear pain (usually on one side)

• Sensation of fullness or pressure in the ear

• Muffled hearing

• Drainage of pus or fluid from the ear (if the eardrum ruptures)

• Fever or general discomfort

• Rarely, dizziness or ringing in the ear

Why does it happen?

The Eustachian tube, which connects the middle ear to the throat, can become blocked during upper respiratory infections or allergies. This leads to fluid buildup, creating an environment for bacteria to grow.

How is it diagnosed?

A doctor in Tel Aviv can diagnose AOM using an otoscope. A bulging, red, or immobile eardrum is a typical finding. If earwax blocks the view, it may be gently removed for better assessment.

Causes

The most common bacteria include:

• Streptococcus pneumoniae

• Haemophilus influenzae

• Moraxella catarrhalis

  • Viruses and less common bacteria like Staphylococcus aureus and Group A Streptococcus can also cause AOM.

Treatment

• First-line treatment is usually Amoxicillin or Amoxicillin-Clavulanate for 5–10 days.

• In case of allergies: Cephalosporins, Azithromycin, or respiratory fluoroquinolones (e.g. Levofloxacin).

• Pain relief with Acetaminophen or NSAIDs.

• If the eardrum ruptures, topical antibiotic drops may be added.

When to see a doctor

Seek evaluation if you experience:

• Persistent or worsening pain

• Fever, drainage, or reduced hearing

• No improvement after 48–72 hours of treatment

• Recurrent infections (more than twice in 6 months)

• Facial weakness or severe dizziness

Complications to watch for:

• Mastoiditis (infection spreading to the bone behind the ear)

• Labyrinthitis (causing vertigo and hearing loss)

• Facial nerve paralysis

• Chronic perforation of the eardrum

• Rarely: meningitis or brain abscess

Important note

Not every ear problem is AOM. Otitis media with effusion (fluid without infection) is often mistaken for AOM. It usually resolves without antibiotics and may only require decongestants or nasal sprays.

If you're staying in Israel and need a doctor in Tel Aviv for ear pain or hearing issues, our clinic is here to help with fast, friendly care.