Yes, an ear infection can affect both ears, but it usually does not spread directly from one ear to the other. More often, the same cold or other illness affects both ears’ drainage tubes, allowing fluid to build up and become infected on either side. Ear infections are not usually contagious, although the viruses and bacteria linked to them can spread. New symptoms in the other ear deserve attention.
Can the same ear infection affect both ears?
Yes. An infection can develop in both middle ears, either at the same time or with symptoms becoming noticeable at different times. The middle ears are separate spaces, and each connects to the back of the nose and throat through a narrow passage called the Eustachian tube. These tubes help maintain pressure and drain fluid from the ears. According to Mayo Clinic, swelling or blockage of these tubes can cause fluid to collect behind the eardrum, creating conditions in which an infection can develop.
When a respiratory illness affects the passages around the nose and throat, both Eustachian tubes may become affected. Fluid can then build up in either middle ear. If germs cause an infection in both ears, the result may be pain, pressure, or reduced hearing on both sides. This does not necessarily mean the original infection physically traveled from one ear to the other.
Is an ear infection contagious?
The ear infection itself is not generally considered contagious, but the germs associated with it can spread between people. According to Cleveland Clinic, viruses and bacteria that cause ear infections include those responsible for common respiratory illnesses, such as colds and flu. These illnesses can contribute to inflammation and fluid buildup in the middle ear.
For example, a child who catches a cold may develop ear pain on one side before experiencing discomfort on the other. The second ear may be affected by the same respiratory illness rather than by direct transfer of the infection across the head. Touching the outside of one ear and then the other does not ordinarily explain why both middle ears become infected.
Does the type of ear infection matter?
Yes. The term ear infection can describe different conditions, and the location of the problem matters. A middle ear infection affects the space behind the eardrum, while swimmer's ear affects the outer ear canal. Fluid may also remain behind the eardrum without an active infection. The Centers for Disease Control and Prevention (CDC) distinguishes these conditions because they have different features and may require different approaches to care.
An infection in one ear canal and discomfort in the other ear do not automatically mean the original problem has spread. The second ear may have a separate issue, or the symptoms may be related to the same underlying illness. A healthcare professional can examine both ears to determine what may be causing the symptoms.
What symptoms may appear in the other ear?
When both ears are affected, the symptoms may be similar on each side, although they do not always feel equally uncomfortable. Examples of symptoms that can occur with an ear infection include:
- Ear pain or aching on one or both sides.
- A feeling of pressure, fullness, or blockage in the ear.
- Muffled hearing or difficulty hearing clearly.
- Fluid or discharge coming from the ear.
- Fever or a general feeling of being unwell.
- In babies and young children, unusual fussiness, difficulty sleeping, reduced interest in feeding, or pulling at the ears.
These experiences can have different causes, and symptoms alone cannot establish whether an infection is present in either ear. Fluid behind the eardrum, for example, may affect hearing even when there is no active infection. A healthcare professional considers the timing of symptoms, recent illnesses, medical history, and examination findings when assessing the problem.
When should you seek medical care?
Arrange a medical assessment if ear pain is getting worse, does not begin to improve within two to three days, or continues to interfere with normal activities. Seek prompt medical advice if there is discharge from the ear, new hearing loss, swelling around the ear, a high fever, dizziness, vomiting, or a marked decline in general well-being. The NHS guidance on ear infections identifies these as reasons for medical review, with urgent advice appropriate for concerning or worsening symptoms.
Age is also important. A baby younger than 12 months with a suspected ear infection should be assessed by a healthcare professional. Earache affecting both ears in a child under 12 months warrants urgent medical advice. If a baby younger than three months has a temperature of 38°C (100.4°F) or higher, seek immediate medical assessment, whether or not ear symptoms are present.
Do not wait for the other ear to become painful before seeking care when concerning symptoms are already present. New symptoms can help a clinician understand how the problem is developing, but the reason for the change needs to be assessed in context.
How can a healthcare professional check both ears?
A healthcare professional will usually ask when the symptoms started, whether they began after a cold, whether the discomfort has changed, and whether there has been fever, discharge, or a change in hearing. The clinician can examine both ears with an instrument called an otoscope, which allows the eardrum and ear canal to be viewed. MedlinePlus explains that an ear examination can help identify findings associated with an acute middle ear infection.
This examination helps distinguish an active infection from fluid buildup or another condition affecting the ear. The findings, along with the person's age, symptoms, and medical history, help determine whether treatment is needed. Antibiotics are not necessary for every middle ear infection, and the appropriate treatment depends on the specific situation.
What can you do while waiting for an assessment?
For temporary comfort, follow appropriate pain-relief advice from a healthcare professional or pharmacist, taking age restrictions and other medical conditions into account. Avoid inserting cotton buds, fingers, or other objects into the ear canal. Do not begin using leftover antibiotics or ear drops without appropriate advice, because the correct treatment depends on the type of ear problem and the condition of the eardrum.
If the other ear starts hurting during recovery, contact the healthcare professional managing the original infection for guidance, particularly if symptoms are worsening or new symptoms appear. The change does not automatically mean the first treatment has failed, but it may mean that both ears need to be examined and the care plan reconsidered.