A double ear infection, also known as a bilateral ear infection, occurs in both ears simultaneously. It can also start primarily on one side and then develop in the opposite side shortly after.

The symptoms of a double ear infection are generally worse than if the infection was occurring in only one ear. The treatment for this type of ear infection is similar to the treatment of a one-sided ear infection.

An ear infection that only affects one ear, also called a unilateral ear infection, can potentially develop into a double ear infection. To determine if both ears are affected, you will have to pay attention to whether symptoms are occurring in both ears.

Symptoms

Symptoms of a double ear infection are similar to those of a unilateral ear infection, but there are some differences between the symptoms of the two infections.

The symptoms of an ear infection can include:

  • Drainage and pus from the ears
  • Difficulty sleeping
  • Hearing loss
  • Irritability
  • Ear pain
  • Fever
  • Nasal congestion
  • Cough or hoarse voice
  • Rhinitis (which causes symptoms similar to those of allergies)
  • Poor appetite

Although these symptoms are present in both types of ear infections, the fever in double ear infections is usually worse. Bulging of the eardrum can also be present in both types of ear infections, but it is more common in double ear infections.

Infant and Toddler Symptoms

Infants and toddlers are often unable to tell what is wrong or what they are feeling. If your child has a fever and is pulling at both of their ears, it could be a sign that they have a bilateral ear infection and you should call your pediatrician.

Treatment

Antibiotics

The treatment for a double ear infection depends on its cause. If it is caused by a virus, no medication is needed. If the infection is caused by bacteria, you will need antibiotics. This is especially true for children younger than 2 years old.

Possible Causes of a Double Ear Infection

Ear infections are typically caused by another type of infection. An upper respiratory infection, which affects the nose, throat, and airways, often leads to an ear infection. In the case of a double ear infection, it can also be caused by not treating a unilateral ear infection properly.

The antibiotic used to treat a double ear infection can come in the form of ear drops or an oral medication, which is taken by mouth. An ear infection is usually treated with the antibiotic amoxicillin, as long as you are not allergic to penicillin.

To help ease the symptoms, you may also use over-the-counter medications such as acetaminophen or ibuprofen. However, ibuprofen should not be taken by children younger than 6 months of age.

Home Remedies

Another thing you can do at home is place a warm compress over your ears. To do this, soak a washcloth in warm water, wring it out completely, and put it over your ears.

If you do try this, make sure to drain all the excess water out of the cloth. Getting water in your ears can lead to swimmer’s ear, an infection of the outer ear canal.

Ear Tubes

Ear tubes are used when the eustachian tubes are not functioning properly, which can encourage the development of chronic or recurrent ear infections. The ear tubes are surgically placed in the ear to help create ventilation to the middle ear, which will help to prevent the buildup of fluids or mucus behind the eardrum.

Ear tubes are typically only used if the double ear infection recurs or does not respond to antibiotics. Since recurrent ear infections can lead to hearing loss, ear tubes may help prevent any long-term health issues, such as speech development delays in children.  

Prognosis

With the proper treatment, double ear infections heal fairly quickly. Antibiotics will clear out the infection, but the symptoms may take up to 10 days or longer to go away.

How Can Chronic Ear Infection in Both Ears Affect You?

Having a chronic ear infection in both ears can lead to complications that affect other parts of your body. Chronic ear infections are not to be confused with recurrent ear infections. Chronic ear infections do not heal, while recurrent ones heal and come back. If you have a chronic bilateral ear infection, talk to your doctor to identify the cause and develop a treatment plan that works for you.

Some complications can arise from a double ear infection. It can spread to other parts of the body and lead to additional health issues. Some complications that can occur include:

  • Brain abscess: A brain abscess is a buildup of pus in the brain caused by an infection. The symptoms include headaches, fever, vomiting, nausea, and neurologic deficits.
  • Bacterial meningitis: This is serious type of meningitis, an infection of the protective membranes around the brain and spinal cord. Symptoms of bacterial meningitis include severe headache, stiff neck, and high fever.
  • Acute mastoiditis: This is an infection of the bone located behind the ear, the mastoid. Symptoms include fever, irritability, earlobe swelling, tenderness and redness behind the ear, drooping of the ear, and ear drainage.
  • Hearing loss: Hearing loss can occur in people with an ear infection, but it is typically temporary.

Although these complications are extremely rare, they can be serious. If you think you have a double ear infection, you should visit your doctor as soon as possible for treatment. 

Summary

A double ear infection is more serious than an ear infection that only affects one ear, but treatment usually clears up the infection quickly. Complications from a double ear infection are rare, but they can be serious. Talk to your doctor if you have symptoms of a double ear infection.

Ear Infection Doctor Discussion Guide

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A Word From Verywell

Double ear infections can be difficult to cope with, but they are generally very treatable and resolve pretty quickly.

To help manage the symptoms while you are undergoing treatment and recovering, you can use home remedies like warm compresses to help relieve the pain or pressure buildup in your ears.

The most important thing to remember is that it is more serious than an ear infection that only affects one ear, thus it requires a trip to the doctor’s office.