Stages of otitis media

Otitis media does not have fixed stages, but an ear infection often follows a recognisable course.

Typical course of acute otitis media

1. Cold or blocked tube: a cold causes swelling and the middle ear stops draining
2. Fluid build-up: fluid collects behind the eardrum, hearing seems muffled
3. Infection: germs multiply, pain and fever begin, and the eardrum bulges
4. Peak: pain is at its worst, usually in the first 24 to 48 hours
5. Rupture (in some): the eardrum may open, pus drains and pain eases quickly
6. Resolution: most children improve in 2 to 3 days and the eardrum heals

After the infection

Fluid may stay behind the eardrum for weeks, up to about 3 months. Hearing can be reduced during this time and usually returns.

When it becomes chronic

If the eardrum does not heal, or infection repeats, a perforation and long-lasting discharge can follow. This is called chronic suppurative otitis media.

Ayurvedic view

Ayurveda sometimes describes illness moving from aggravation of Kapha to Pitta (pus formation) to discharge. This is an interpretive idea, not a medical staging.

Timing for review

Most children are re-checked if symptoms do not improve in 48 to 72 hours, or if fluid and hearing problems last more than 3 months.

symptoms are worse after 2 days, or fever returns after improving.