A chronic, long-term infection in the ear may have less severe symptoms than an acute infection. It may go unnoticed and untreated for a long time.

Symptoms include:

• Ear pain or discomfort, earache
  • Usually mild
  • May feel like pressure in the ear
• Fever
• Fussiness
• Pus-like drainage from the ear
• Hearing loss

Note: Symptoms may be continuous or come and go, and may occur in one or both ears.

An examination of the ear may show:

• Dullness
• Redness
• Air bubbles
• Fluid behind the eardrum
• Draining fluid from the eardrum
• A hole (perforation) in the eardrum
• The eardrum bulges out or pulls back inward

Tests may include:

• Cultures of the fluid may show bacteria, and these bacteria may be resistant or harder to treat than the bacteria commonly involved in an acute ear infection.
• Skull x-rays or a CT scan of the head or mastoids may show that the infection has spread beyond the middle ear.
• Hearing tests may be needed.