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Infection can affect the ear canal (otitis externa), the eardrum, or the middle ear (otitis media). Most ear injuries are caused by pressure changes during direct injury (such as a blow to the ear) or sport scuba diving, but, a persistently painful ear may signal an infection that requires treatment. A painful ear with decreased hearing is often the result of otitis media, an middle ear infection.

If infection develops, continue antibiotics for at least five days after all signs of infection have cleared. Because an ear scope (otoscope) may not be available to examine the canal and inner ear in remote locations, starting therapy may be appropriate until a doctor can be reached.

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