An inner ear infection affects everything from the eardrum inward to the sinuses. The passage from the sinuses is fairly small and lends itself to easy obstruction—especially in the presence of other infections.
Initially an inner ear infection may present as a pain to the face (especially cheek bones) and could manifest at the ears. A patient’s history will frequently include reports of a recent cold that included sinus involvement (running nose, excess mucus).
Again, like most medical conditions, anything that co-exists with a fever and severe pain or altered mental status should be considered high-risk. Because of the role of the inner ear on balance, an additional red flag is loss of balance and nausea that leads to vomiting.
Because of the risk of obstruction, and the associated infection, this type of illness is at risk for sepsis. If the infection builds enough pressure the eardrum can rupture.
Since this is mostly a closed system (or one that is easily closed), we are concerned with congestion. Sudafed (or other decongestants) would be helpful here.
Infections that do not self resolve will need antibiotics.