Ear infections are a common health concern, particularly among children. Most people are familiar with single ear infections, however, there is a lesser-known condition called double ear infection or bilateral ear infection. It occurs when both ears are simultaneously affected by infections, says Dr Shirish Shelke, consultant ENT, Apollo Clinic, Pune. This condition can be severe and debilitating than single ear infections, and thus, require prompt diagnosis and appropriate treatment to prevent complications.
A few months ago, Shalini Roy, an eight-year-old from Pune, experienced persistent pain in both ears following an upper respiratory infection. Shalini has had previous episodes of ear infections, hence, her mother, Kogkona Roy consulted a paediatrician who observed redness and fluid accumulation in her ears. “The doctor diagnosed her with double ear infection, which happens on rare occasions,” Kongkona recalls.
Symptoms of double ear infection
The symptoms of a double ear infection are similar to those of a single ear infection. Dr Shelke lists some common symptoms:
Ear pain: The most common and noticeable symptom is sharp, throbbing pain in both ears. Children may express this through constant crying or tugging at their ears.
Ear drainage: Pus or discharge may ooze from both ears, indicating an infection.
Fever: Fever of 100.4°F (38°C) lasting for at least 48 hours along with pain in ears.
Moreover, infants can show symptoms like irritability, refusal to feed, excessive crying, frequent touching of ears or scratching ears, says Dr Anupal Deka, principal consultant, department of ENT, Max Super Speciality Hospital, Dehradun.
What causes a double ear infection?
“Causes of double ear infection are viral, bacterial and fungal infection,” says Dr Shelke. Germs from upper respiratory infections spread to the ear canal, thereby causing infection, adds Dr Deka. The eustachian tubes (which connect the middle ear to the back of the throat) may expand and become inflamed due to this condition.
These tiny tubes aid in preserving normal ear pressure. “Fluid can accumulate behind the eardrum as the tubes swell and get clogged,” says Dr Deka.
In this fluid, bacteria can swiftly multiply and cause infection and irritation, he adds. “Due to the fact that their eustachian tubes are not as vertical as adults, children are more susceptible to ear infections.”
A double ear infection may also be caused by enlarged adenoids, which are tissue pads located at the back of the nose, especially in young children, says Dr Deka.
Can an ear infection spread from one ear to the other?
Unilateral ear infection can turn into a bilateral infection, says Dr Shelkar.
“Although they are less frequent than single-ear infections, bilateral ear infections can cause issues in the opposite ear if a unilateral infection is left untreated,” says Dr Deka. Therefore, treating an infection in one ear promptly is crucial to avoid a double ear infection.
Diagnosis
A double ear infection is identified after a doctor reviews the medical history and physical symptoms of an individual, says Dr Deka. Moreover, the expert looks for redness, swelling, and fluid behind the eardrum. The extent to which the eardrum responds to pressure may be measured by the expert. “If the eardrum does not respond to this pressure, fluid buildup behind the ear may be the cause,” says Dr Deka.
“For diagnosis, instruments like otoscope can be used. In some instances, an endoscope or microscope may be needed,” says Dr Shelke.
How to treat a double ear infection?
According to Dr Shelke, treatment typically involves a combination of these approaches:
- Treatment for bacterial ear infection includes oral antibiotics and antibiotic ear drops. Sometimes nasal decongestant drops and painkillers may also be given by the doctor.
- For viral infection, symptomatic treatments such as pain killer and anti-cold medicine are generally advised by an expert.
- Fungal infection may need ear cleaning by an ENT specialist and antifungal ear drops.
Shalini was prescribed a week-long course of antibiotics and pain relief medication. Her symptoms started to subside after three days and she eventually recovered after completing the treatment. Moreover, her doctor also confirms no signs of infection in the follow-up.
Complications and risk of double ear infection
According to Dr Deka, infections that are persistent or recurrent can result in:
- hearing issues
- a torn eardrum
- delays in children’s speech development
- infection spreading
“The biggest concern in relation to severe and persistent ear infections are permanent hearing loss and long-term speech issues,” says Dr Deka. The eardrum may sustain damage in more serious circumstances. The torn eardrum may heal within a few days, however, in some cases it might need a surgery, he adds. A double ear infection can spread to other areas of the body, just like any other condition. The area of the skull bone behind the ear known as the mastoid is the most vulnerable.
Prevention
“Early diagnosis is necessary to initialise treatment. Avoid water from entering the ears. Treat common cold and upper respiratory tract infections at the earliest,” says Dr Shelke.
A few tips recommended by Dr Deka are:
- Regular hand washing can help reduce the spread of colds and flu.
- Avoid sick people, keep children out of daycare centres when sick, and encourage them to not share their utensils with others.
- Prevent being around tobacco smoke.
- Maintain a vaccination schedule, including the flu shot.
