Ear Infection - Viral
Definition
- A viral infection of the middle ear (the space behind the eardrum)
Call or Return If
- Fever lasts more than 3 days
- Ear pain becomes worse
- Ear discharge occurs
- You think your child needs to be seen
- Your child becomes worse
About This Topic
Symptoms
- Mild or moderate earache
- Younger children may act fussy or poke at their ear
- The main symptom may be ear congestion
- Symptoms of a common cold also present. This includes a runny or congested nose, and a cough.
Diagnosis
- A doctor can diagnose a viral ear infection by looking at the eardrum. It will be red but not bulging.
Cause
- Blocked eustachian tube, usually as part of a common cold. The eustachian tube joins the middle ear to the back of the throat. Blockage results in middle ear fluid (called viral otitis).
- A viral ear infection sometimes turns into a bacterial one. If the fluid becomes infected, the fluid turns to pus (bacterial otitis).
- This causes the eardrum to bulge out and can cause lots of pain.
After Care Advice
Overview:
- Most viral ear infections get better on their own.
- Your main job is to control the pain.
- Here is some care advice that should help.
Pain Medicine:
- To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
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.
Antibiotic Not Needed:
- Antibiotics don't help viral infections.
- They can only kill bacteria.
Nasal Washes To Open a Blocked Nose:
- STEP 1: Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use warm tap water. Put 3 drops in each nostril. (If age under 1 year old, use 1 drop. Also, do 1 side at a time.)
- STEP 2: Blow (or suction) each nostril out while closing off the other nostril. Then, do the other side.
- STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
- How often: Do nasal washes when your child can't breathe through the nose. Limit: No more than 4 times per day.
- Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
- Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
- Reason for nose drops: Suction or blowing alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
- Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
- For young children, can also use a wet cotton swab to remove sticky mucus.
Medicines for Colds:
- Age Limit. Before 4 years, never use any cough or cold medicines. Reason: Unsafe and not approved by the FDA. Also, do not use products that contain more than one medicine.
- Cold Medicines. They are not advised. Reason: They can't remove dried mucus from the nose. Nasal washes are the answer.
- Decongestants. Decongestants by mouth (such as Sudafed) are not advised. They may help nasal congestion in older children. But, decongestant nasal spray is preferred after age 12.
- Allergy Medicines. They are not helpful, unless your child also has nasal allergies. They can also help an allergic cough.
What to Expect:
- Most children get better slowly over 2 to 3 days.
- Ear congestion may last until the cold is gone.
Return to School:
- Your child can return to school or child care when any fever is gone.
- Your child should feel well enough to join in normal activities.
- Ear infections cannot be spread to others.
