Pediatric doc here. True, many are not bacterial but fungal ear infections are quite rare. The majority of otitis media is viral, which is not surprising given the concurrent URI that most kids (and adults) have when they get a painful ear. This is also the reason I try to have parents wait out ear infections in their kids ... I&#x27;d rather not use antibiotics, especially when they have a viral infection that wouldn&#x27;t respond anyway. I&#x27;m not sure what tools you&#x27;re referring to in the ENT office. If the ear infection is external (i.e. Swimmer&#x27;s Ear) any GP office should be able to culture and treat it. If it&#x27;s a middle ear infection (and that&#x27;s usually what we&#x27;re talking about), an ENT still has to deal with the fact that the tympanic membrane blocks access to the middle ear. Only in very extreme cases would an ENT consider violating the TM to sample the middle ear.