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An examination of the ear may show dullness, redness, air bubbles, or fluid behind the eardrum. The eardrum may show drainage or perforation (a hole in the eardrum). The eardrum may bulge out or retract inward.
Cultures of drainage may show bacteria. These bacteria may be resistant or harder to treat than the bacteria commonly involved in acute ear infection.
Mastoid x-rays or a CT scan of the head or mastoids may show spreading of the infection beyond the middle ear.
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