Ruptured Infected Eardrum (Child)

”Eardrum

The middle ear is the space behind the eardrum. Your child has an infection of the middle ear. This can lead to pressure that causes the eardrum to break (rupture). This may cause sudden pain. Pus or blood will drain out of the ear canal. Your child’s hearing will also likely be affected.

The infection may be treated with antibiotics. The eardrum usually heals completely on its own. If it does not, further treatment is needed. For this reason, it’s important to have a follow-up exam with an ear specialist.

Home care

  • Keep giving your child prescribed antibiotics until all of the medicine is gone. Do this even when he or she feels better after the first few days.

  • Give any other medicines as prescribed.

  • Don't smoke around your child. Smoking in the household is a major risk factor for ear infections.

  • Keep a clean cotton ball in the ear canal to absorb drainage. Change the cotton often, when it becomes soiled with fluid drainage. Don’t let water get into the ear. Don’t put any medicine drops into the ear unless your child’s provider tells you to do so.

  • Give your child plenty of fluids and healthy food.

  • Keep your child at home and resting until any fever is gone and your child is eating well and feeling better.

Follow-up care

Follow up with your child’s healthcare provider in 2 weeks, or as advised. This is to make sure the infection is getting better and the eardrum is healing. Also follow up with your specialists as advised for a hearing test or exam.

When to seek medical advice

Unless advised otherwise, call your child's healthcare provider if your child has:

  • Fever (see Fever and children, below)

  • Pain that gets worse or doesn’t get better

  • Unusual fussiness, drowsiness, or confusion

  • Seizure

  • Headache, neck pain, or stiff neck

  • New rash

  • Frequent diarrhea or vomiting

  • Inability to turn head or open mouth

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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