What else might it be?

Conditions which cause ear pain or deafness sometimes ‘present’ with symptoms suggesting an ear infection:

• Otitis externa, an infection of the ear canal, usually affects older children and adults. Typically there will be an itchy or painful, inflamed ear canal. If the ear drum can be seen, it may be normal but the ear canal may often be occluded by debris
• Otitis media with effusion (glue ear), is where fluid collects in the middle ear without signs of acute infection. Parents/carers may be concerned about inattention or mishearing, difficulty communicating, asking for things to be repeated, or listening to the television at excessively high sound levels
• Chronic suppurative otitis media is diagnosed if there is persistent inflammation and perforation of the tympanic membrane with draining of discharge for more than two weeks. These cases need referral
• Foreign body in ear canal. Children may have put something in their ear and parents may not know of this. A great deal of care is required in order not to push the object deeper into the ear canal or damage the ear canal so most cases should be referred
• Ear wax. An accumulation of earwax most commonly causes hearing loss but is also associated with a sensation of a blocked ear, with either ear discomfort or earache. While commonly seen in older people, it does occasionally cause problems in children and young adults.