The most common causes of ear pain in a child are the following pathological conditions:
- otitis media;
- lymphadenitis;
- infectious mumps;
- trigeminal neuralgia;
- traumatic injury to any part of the ear or parotid region;
- caries or other inflammatory processes in the oral cavity;
- foreign body in the ear;
- a bite of an insect.
Some of the listed pathological processes are accompanied by an increase in temperature, others can proceed at normal rates. For effective treatment, it is important to clarify the location and nature of the pathological process. The appointment of the correct treatment depends on this.
Diagnosis of otitis media
The most common reason a child has ear pain and fever is otitis media. The development of the inflammatory process in any part of the ear is manifested by just such symptoms.
Usually, with otitis media, children complain of intense, throbbing, bursting pain in the ear.
In addition to pain, they may complain of tinnitus, hearing loss. With a pronounced pathological process and its spread to the area of the inner ear, symptoms such as dizziness, nausea, and impaired coordination are noted. In cases where, due to his age, the child cannot express his complaints, his behavior is very pathognomonic:
- marked anxiety is noted;
- crying and periodic screaming;
- the child shakes his head;
- tries to touch the affected ear with a hand or scratch the earlobe;
- refuses to eat.
The presence of hyperthermia up to 38-39 degrees is characteristic. However, the disease can also have a sluggish course, in which clinical symptoms develop against a background of subfebrile or even normal temperature. When measuring the temperature in the ear, it must be borne in mind that the temperature in the child's ear is 36.5 - 38 degrees, that is, higher than in the armpit, on average, by 1 degree.
Infrared thermometers are not used for otitis media due to the unreliability of the results.
A very obvious symptom, although unstable, is suppuration. It is characterized by a yellowish, sticky exudate that appears in the external auditory canal. Due to the peculiarities of the development of the ear in children, this symptom may appear already in the first hours after the onset of the disease. This symptom is not typical for any other pathological process in the parotid region.
Suppuration is characterized by a purulent inflammation of the middle ear. Usually the disease has a benign course. However, untimely and incorrect treatment in some patients can lead to the development of severe complications.
High fever and soreness of the ear is also noted in such pathological processes as mastoiditis, meningitis, and brain abscess. These conditions are extremely dangerous and can be fatal. In this regard, timely diagnosis of otitis media and the appointment of correct treatment are very important.
The different nature of ear inflammation, catarrhal or purulent, determines the characteristics of the treatment tactics. With catarrhal otitis media, excellent results can be achieved without antibacterial agents, while purulent inflammation forces antibiotic therapy, the use of drugs, both local and systemic. Antibiotic therapy for catarrhal otitis media is resorted to only in case of ineffectiveness of treatment during the first two days, the presence of severe concomitant pathology, as well as severe violations of the general condition.
Ear abscess and foreign body
The presence of bloody or rusty discharge from the ear may indicate a traumatic injury.
With insufficient antiseptic treatment of the skin, there is a risk of infection, which will also manifest itself in the development of symptoms when the child has ear pain and fever. For the development of an abscess, depending on the area of the lesion, the presence of severe local or diffuse pain is characteristic. In addition, ear redness and localized fever are important symptoms. In the case of a severe course, the development of hyperthermia to subfebrile numbers is noted.
An increase and soreness of regional lymph nodes also testifies in favor of purulent inflammation.
Depending on the clinical manifestations, treatment in this case can be the use of local antibacterial agents, both in the form of an ointment and ear drops, as well as antiseptic and anti-inflammatory drugs. The most popular local remedies in this case are Bactroban ointment, Cipromed ear drops, as well as external antiseptics.
The development of similar symptoms can also be characterized by the presence of a foreign body in the ear. The child will be restless trying to touch the affected ear. In case of untimely detection of an object in the ear, there is a risk of not only injury, but also infection of the skin of the ear. Parents should not try to remove the foreign body on their own. Otherwise, it can sink even deeper or injure the eardrum. A specialist with special tools and skills should help in solving this problem.
A bite of an insect
Severe ear pain and fever in a child may be the result of an insect bite, for example, a bee, wasp. Diagnostics in this case does not cause any difficulties. Pain syndrome with an insect bite develops sharply. Within a short time, there is a swelling of the auricle, its hyperemia. Itching of the skin may occur.
As a means of first aid, antihistamines are used inside and in the form of external drugs. An insect bite can manifest itself in the form of an allergic reaction, up to Quincke's edema. If the condition worsens, the appearance of severe malaise, loss of consciousness, the patient should immediately be taken to a medical institution and examined by a pediatrician, if necessary - by an ENT doctor.
Infectious parotitis
Symptoms, when a child has ear pain and a temperature of 38 degrees, is also characteristic of mumps. At the same time, despite the presence of general complaints with otitis media, there are distinctive features inherent in this particular disease:
- soreness of muscles and joints;
- dry mouth;
- increased pain in the ear when chewing;
- swelling and soreness in the parotid salivary glands;
- painful palpation of the area behind the earlobe;
- symmetry of the lesion.
The presence of a pear-shaped face of the patient, pain on palpation of the salivary glands, an epidemiological history allow us to confidently determine the causes of pain in the ear area and diagnose mumps. Correct treatment in this case will be prescribed by the attending pediatrician or infectious disease specialist.
Stomatitis
With irradiation of pain in the ear, inflammation of the oral cavity can also occur.
In this case, the study of the oral mucosa allows you to detect the presence of herpetic formations, erosive surfaces, accompanied by pain, bleeding. In most cases, stomatitis is characterized by the development of hyperthermia in children up to 39 degrees. However, even if the child indicates pain in the ear, pathological foci located in the oral cavity bother him more significantly.
In some cases, especially when the child is too young, it can be difficult to diagnose otitis media.It is possible to determine whether it is really about ear inflammation, or whether the pathological process is localized in another place, giving it to the ear, by pressing on the tragus. During this manipulation, air pressure increases in the external auditory canal and, consequently, on the eardrum and middle ear. The inflamed mucous membrane of the tympanic cavity reacts to this action by increasing the pain syndrome. The child screams. This is a confirmation of the inflammatory process in the ear.
To help diagnose otitis media, the fact that ear inflammation is more often a secondary disease, complicating ARVI, sinusitis, and childhood infectious diseases, may also indicate. The presence of a runny nose, nasal congestion, preceding the development of these symptoms, testifies in favor of ear disease.
The risk group for the development of otitis media includes children with enlarged adenoids.
The main task in this situation facing the child's parents is to get immediate consultation with an otolaryngologist. It is likely that we will talk about catarrhal otitis media, and the use of ear drops with an antiseptic and anti-inflammatory component will be able to stop the process in a short time, preventing it from transforming into a purulent one. However, only a qualified specialist can decide on the treatment tactics. Self-medication in this case can lead to the development of purulent otitis media, chronic course, or severe and dangerous complications.
