Infections of the middle ear, called otitis media are quite common in young children. These infections usually result from the spread of infection from the mucous membrane of the pharynx through the auditory tube. The symptoms of low-grade fever, lethargy, and irritability, and pulling at the ear are not often recognized by the parent as signs of middle ear infection. The infection also can cause a temporary decrease or loss of hearing because fluid build up can dampen the tympanic membrane. In extreme cases, the infection can damage or rupture the tympanic membrane. Chronic middle ear infections increase the chances of inner ear infections. Inner ear infections can decrease the inner ear’s detection of sound and maintenance of equilibrium.