Inner ear infections can affect both hearing and balance systems. Either a bacterium or a virus causes the infection, and although the symptoms of the two types of infections mimic each other, they're treated differently. Symptoms may include disturbances in hearing, such as ringing in the ears, hearing loss, dizziness, or difficulty with vision or balance. Bacterial inner ear infections are usually caused by chronic, untreated middle ear infections, or may be a result of bacterial meningitis (men-in-JI-tis), or an injury. Diagnosis generally involves a health care provider completing a thorough physical examination, and checking for signs of a middle ear infection. Treatment usually involves taking antibiotics to kill the bacteria. Less is known about viral inner ear infections, but it's generally assumed that the viruses enter the ear through the bloodstream. Since antibiotics have no affect on viral infections, treatment often involves taking medication to relieve the symptoms. If treated promptly, many inner ear infections cause no permanent damage. In some cases, however, permanent hearing loss can result.