Ear Infection - Ruptured Eardrum

Symptoms

Cloudy fluid or pus draining from the ear canal is the main symptom
The cloudy fluid may be blood-tinged.
Before the drainage happens, usually the child reported an earache. The ear pain decreases after the eardrum ruptures. Reason: the pressure in the middle ear goes away.
Younger children will cry, act fussy or have trouble sleeping because of pain.
About 50% of children with an ear infection will have a fever.
Symptoms of a common cold are often present. This includes a runny or congested nose, and a cough.

Diagnosis

Normally a doctor can diagnose a bacterial ear infection by looking at the eardrum. It will be bulging and have pus behind it.
If the eardrum ruptures, the eardrum can't be seen because it's covered with pus. So the presence of the discharge makes the diagnosis.

Cause

In 5% to 10% of bacterial ear infections, the eardrum will rupture. This means it develops a small tear or hole in it. This is from the buildup of pressure in the middle ear.
The ear then drains cloudy fluid or pus.
This small hole most often heals over in 2 or 3 days.
Ear infections peak at age 6 months to 2 years. They are a common problem until age 8.
The onset of ear infections is often on day 3 of a cold.
How often do kids get ear infections? 90% of children have at least 1 ear infection. Frequent ear infections occur in 20% of children. Ear infections are the most common bacterial infection of young children.

Overview:

Pus draining from the ear canal means the eardrum has ruptured. This occurs in 5 to 10% of ear infections.
Discharge can also occur if your child has ear tubes and an ear infection.
Most often, the small tear heals quickly after antibiotics are started.
Here is some care advice that should help.

Antibiotic by Mouth:

Bacterial ear infections need a prescription for an antibiotic.
The antibiotic will kill the bacteria that are causing the ear infection.
Give the antibiotic as directed.
Try not to forget any of the doses.
Give the antibiotic until it is gone. Reason: To stop the ear infection from flaring up again.

Fever:

For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.

Pain Medicine:

To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.

Cold Pack:

Put a cold wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work. Note: Some children prefer heat for 20 minutes.
Caution: Do not keep a hot or cold pack on too long. This could cause a burn or frostbite.

Ear Discharge:

Wipe the discharge away as you see it. Reason: Pus is irritating to the skin.
Do not plug the ear canal with cotton. Reason: Retained pus can cause an infection of the lining of the ear canal.

Limits:

Do not allow swimming in children with a hole in the eardrum. Can return to swimming after your doctor has checked that the hole is healed.
Air Travel. Children with ear infections can travel safely by aircraft if they are taking antibiotics. For most, flying will not make their ear pain worse.
Give your child a dose of ibuprofen 1 hour before take-off. This will help with any pain they might have. Also, during descent (coming down for landing) have your child swallow fluids. Sucking on a pacifier may help as well.

Avoid Eardrops:

What to Expect:

Once on antibiotics, your child will get better in 2 or 3 days.
The fever should be gone by 2 days (48 hours).
The ear pain should be better by 2 days. It should be gone by 3 days (72 hours).
The hole heals over in 1 to 2 days. The drainage stops soon after that.

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