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Ear Infection Without a Fever?

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: Is it possible that my son could have an ear infection without fever and only pain when the ear is touched? Could this be swimmer's ear? If so, does it need to be treated?

A: It sounds as if your son does have "swimmer's ear." There are two types of ear infections -- otitis media (a middle ear infection) and otitis externa ("swimmer's ear," or an infection of the external ear canal). Otitis media is most common in infants and young children and is characterized by fever, fussiness, and ear pain. Pediatricians usually treat otitis media with an oral antibiotic. On the other hand, otitis externa ("swimmer's ear") occurs when water gets into the ear canal and does not drain out properly. The skin of the outer ear canal then becomes irritated and infected.

During a bout of swimmer's ear, it is painful when the outer ear is touched or moved. Sometimes itchiness in the ear canal may occur before the pain. You may see yellow or whitish drainage coming from the ear canal. Your son's hearing may also be affected, as sound is blocked due to the swelling and inflammation of the skin of the ear canal. However, once the infection is treated, his hearing will return to normal. Fever is uncommon.

The treatment for swimmer's ear is to use prescription eardrops that kill the bacteria causing the infection and reduce the swelling and inflammation. To help relieve your son's ear pain, you can give some acetaminophen by mouth. Sometimes a warm cotton cloth or heating pad to the outside of the ear offers some relief. While the infection is being treated, it is important to keep the ear dry. Avoid getting more water in the ear canal with bathing and showering. Swimming is okay, but keeping your child's head out of the water until the infection has cleared is important.

To prevent future infections, be sure your son dries his ears immediately after swimming. Some people suggest using eardrops with alcohol in them to help keep the ear canal dry. Talk with your son's pediatrician about what she might recommend.

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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.


Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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