Ear Infections

Earache is a common occurrence in childhood and may have a number of causes. Infected fluid may accumulate behind the eardrum, or external ear canal may become infected. Children may also complain of ear pain with a sore throat.

Middle Ear Infection

Middle ear infection is a common complication of a cold in children. The middle ear space lies behind the eardrum and contains three tiny bones that transmit sound to the nerve endings of the inner ear. The Eustachian tube ventilates the middle ear space into the back of the throat. Swelling and congestion due to a cold may obstruct the Eustachian tube and allow fluid to fill the middle ear space. This fluid may then become infected.

Indications of middle ear infection include irritability, sleeplessness, earache and fever. Infants may or may not tug or rub the ear. Infants may also have vomiting or diarrhea associated with an ear infection.

The pain of a middle ear infection can often be relieved with acetaminophen (Tylenol) and heat applied to the external ear with a heating pad or warm compress. If there is no ear canal discharge, numbing drops, such as Auralgan or Otocaine, may be used. Ear pain will usually subside after a few hours but the infection will remain. The child should be checked within a day after onset of symptoms. Note: Numbing drops should not be given to a child who has tubes in the eardrum.

Middle ear infections are generally treated with an oral antibiotic. If a child has not shown improvement within 2-3 days, the ears should be checked again. Regardless, the child should be checked a few days after completing the antibiotic to be sure the infection and fluid have resolved.

External Ear Infection

External ear infection (swimmer’s ear) is an infection of the ear canal down to the eardrum, which may affect the middle ear space as well. Moisture trapped within the ear canal damages the skin and encourages the growth of bacteria or fungi. The main symptom is ear pain, which often begins gradually and increases with continued exposure to water. Mild soreness of the ear may be treated with drying alcohol-based ear drops (Swim Ear). If the pain is persistent or an unusual discharge is noted from the ear, the child should be examined.

Other Causes:

Ear pain may also be caused by middle ear pressure with or without fluid, dental problems, local skin conditions and foreign bodies in the ear canal. In general, ear pain that is severe, persistent, or associated with a cold, fever, or other signs of illness may be serious and does require a physician’s examination.



Posted in: Pediatric Topics