Ear Infections in Children: Symptoms and Treatments

Common cold complicated by otitis media?

Hello, doctor.
My 10-year-old child, who is in the fifth grade, initially had yellow phlegm and has been coughing for three weeks with yellow sputum.
I thought he would recover on his own, but his cough has worsened over the past two days, and today he coughed so much that he has a headache.
I took him to the clinic, and the doctor diagnosed him with otitis media.
The doctor prescribed DINCO SYRUP CENTE for cough relief, a bottle of Abcot for expectoration, 9 tablets of Antholin for cough relief, 9 tablets of Berotec for bronchospasm relief, 6 tablets of Augmentin, 6 tablets of Scanol Gra, and 5 tablets of Mylanta, and 5 tablets of Periactin.
All these medications are to be ground into powder and taken three times a day for three days.
After taking the first dose, my child said his legs were shaking and he felt weakness in his limbs.
Is this normal? I am quite worried that he might have some complications from the otitis media.
Did the doctor prescribe antibiotics? If so, what is the name of the medication? What are the medications that were prescribed?

Wenwen, 40~49 year old female. Ask Date: 2018/09/04

Dr. Xiao Kaiwen reply Pediatrics

Berotec is a bronchodilator, and the most common side effect is tremors in the hands and feet; however, these symptoms will resolve after discontinuation of the medication.
Whether there is a need to continue using it should be discussed with your physician.
Augmentin is an antibiotic.
It is important to determine if there is otitis media or other complications, which can only be assessed through an in-person evaluation of the patient; therefore, I cannot comment on that here.
I can only say that a cough lasting for three weeks is likely not just a simple cold and may indicate other possibilities, such as bronchial allergies or mycoplasma infection, among others.

Reply Date: 2018/09/04

More Info

Understanding ear infections in children, particularly middle ear infections (otitis media), is crucial for parents and caregivers. These infections are common in children due to their anatomical structure, where the Eustachian tubes are shorter and more horizontal, making it easier for bacteria and viruses to reach the middle ear.

Symptoms of Ear Infections
Children with middle ear infections often exhibit a range of symptoms, including:
1. Ear Pain: This is the most common symptom. However, not all children will express discomfort. In your case, the child did not show signs of ear pain when you pulled on his ear, which can sometimes make diagnosis tricky.

2. Fever: A fever is common, especially if the infection is acute.
3. Coughing and Nasal Congestion: As you mentioned, your child had a cough and yellow phlegm, which can indicate a respiratory infection that may lead to an ear infection.

4. Headaches: The child’s headache could be related to the infection or could be a result of sinus pressure or other factors.

5. Hearing Issues: Children may experience temporary hearing loss due to fluid buildup in the middle ear.

6. Irritability or Difficulty Sleeping: Children may become more fussy or have trouble sleeping due to discomfort.

Diagnosis of Ear Infections
To determine if a child has an ear infection, a healthcare provider typically performs a physical examination using an otoscope to look for signs such as:
- Redness or bulging of the eardrum
- Fluid behind the eardrum
- Reduced mobility of the eardrum when air is pushed into the ear canal

Treatment Options
The treatment for ear infections often involves:
1. Antibiotics: If the infection is bacterial, antibiotics like Augmentin may be prescribed. It's important to complete the full course of antibiotics to ensure the infection is fully cleared.

2. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate pain and reduce fever.

3. Observation: In some cases, especially with mild infections, doctors may recommend a wait-and-see approach, as many ear infections resolve on their own.

4. Surgery: For recurrent ear infections, some children may require the placement of ear tubes to help drain fluid and prevent future infections.

Concerns About Side Effects
You mentioned that your child experienced shaking and weakness after taking the prescribed medications. Berotec, a bronchodilator, can cause tremors as a side effect. If these symptoms persist or worsen, it's crucial to consult the prescribing physician. They can assess whether the medication is necessary or if an alternative treatment should be considered.

Complications of Ear Infections
While most ear infections resolve without complications, untreated or recurrent infections can lead to:
- Hearing Loss: Temporary hearing loss is common, but chronic infections can lead to permanent damage.

- Speech Delays: Hearing loss can affect speech development in young children.

- Spread of Infection: In rare cases, infections can spread to nearby structures, leading to more serious conditions like mastoiditis or meningitis.

When to Seek Further Care
If your child has a high fever lasting more than a few days, persistent pain, or if symptoms worsen despite treatment, it is essential to seek medical attention. Regular follow-ups with a pediatrician or an ENT specialist can help monitor the child’s condition and prevent complications.

In summary, ear infections in children can present with various symptoms, and while they are common, they require careful management to prevent complications. Always consult with a healthcare provider for personalized advice and treatment options.

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