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Ear Infections and High Fevers
Q: My daughter often gets ear infections. More often than not, she gets this very high fever before the pain sets in from the infection. What is going on and why?
A: First, how common are ear infections? VERY! They happen to lots of children--two out of three children will have had at least one ear infection by their second birthday.
Second, why do ear infections happen? The Eustachian tube that conects the "middle" ear (the area behind the eardrum when we look in the ear from the outside) to the back of the throat doesn't always work as well as we'd like. It can get clogged with mucus from colds or allergies because of its small size and horizontal positioning (particularly in younger kids). This predisposes to fluid collection and poor drainage from the middle ear.
Third, what about the fever and pain? If this fluid can't drain and then gets infected with germs, particularly bacteria, inflammation and pain can result in the middle ear. But each child and each ear infection is different. Some children just poke at their ears. Some get fever, low or high. Others complain of pain, pointing to the ear or throat. It may start after a few days of a cold, giving a little time for the germs to settle in and cause infection in the middle ear, or it may be found coincidentally when your child is seemingly well.
Finally, how are they treated? Your child's doctor will often prescribe an antibiotic to treat the infection. Realize that it may take up to three or four days for the pain and fever to get better. If these symptoms are not going away or your child just isn't getting better, touch base with her doctor to see if anything else is recommended.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.