An ear infection occurs when there is inflammation in the ears. The ear can be divided into the external ear, middle ear and inner ear. Most commonly ear infections occur in the middle ear called otitis media, however, it can also occur in the external ear called otitis externa and inner ear called otitis interna. Ear infections can be caused by bacterial, viral or fungal infections, allergies, sinus infections, injury or trauma to the ear, foreign body in the ear, cold and flu. Common signs and symptoms of ear infections are earache or pain, itchiness in the ear, feeling of pressure in the ear, ear discharge, fever, reduced hearing, headache and difficulty sleeping. Ear infections can be diagnosed by otoscope examination of the ears, tympanometry and ear swab for culture and sensitivity.