Many conditions, lifestyle choices, medicines, and diseases interfere with your ability to heal or fight infection. You may be at risk for a more serious problem from your symptoms if you have any of the following. Be sure to tell your health professional.

Conditions

• History of a birth defect, surgery, chronic infection, or injury in or near the ear, mouth, or jaw
• History of significant hearing loss
• A known perforation of the eardrum
• Previous surgery to remove the spleen (splenectomy)
• Prior ear surgery
• Problems with thinking and reasoning, such as an intellectual disability or Alzheimer's disease
• Tubes in the ears
• Younger than 5 years of age

Lifestyle choices

• Alcohol abuse or withdrawal
• Drug abuse or withdrawal

Medicines

• Corticosteroid treatment
• Medicines to prevent organ transplant rejection
• Medicines used to treat cancer (chemotherapy)
• Radiation therapy

Diseases

• Cancer
• Diabetes
• Hemophilia
• Human immunodeficiency virus (HIV) infection
• Idiopathic thrombocytopenic purpura (ITP)
• Malnutrition
• Sickle cell disease