Hygiene

By Dr Susan Wang, Independent GP consulting from HealthMint Croydon

Ear infections and viral illnesses can cause many of the same symptoms in young children, including fever, irritability, poor appetite and disturbed sleep. A middle ear infection can also develop during or after a cold, which can make it difficult to tell what is causing your child’s symptoms based on behaviour alone.

If you are unsure, a GP can examine your child’s ears and assess whether there are signs of a middle ear infection or another cause for their symptoms. HealthMint provides children’s health care through GPs consulting at Cranbourne North and Croydon.

Key Takeaways

• Viral illnesses and middle ear infections can cause similar symptoms in babies and young children.
• Ear pain, ear rubbing, irritability, fever and poor sleep can occur with a middle ear infection, but symptoms alone do not confirm the diagnosis.
• A GP can use an otoscope to look at the eardrum for signs of a middle ear infection.
• Many middle ear infections improve without antibiotics.
• If your child seems unwell or you are concerned about their symptoms, a GP can assess what may be happening and discuss appropriate care.

Why can an ear infection look like a virus?

Middle ear infections, also called otitis media, commonly occur in young children and often begin during or after a cold. When a child has a viral respiratory infection, swelling can affect the Eustachian tube that connects the middle ear to the throat. Fluid may then build up behind the eardrum and sometimes become infected.

That is why the symptoms can overlap. A child with either a viral illness or an ear infection may have a fever, reduced appetite, low energy or irritability.

In babies and toddlers, it can be even harder to tell because they may not be able to explain that their ear hurts.

What might suggest a middle ear infection?

Some children with a middle ear infection may experience:

• Ear pain
• Pulling or rubbing at the ear
• Fever
• Increased irritability or crying
• Reduced appetite
• Disturbed sleep
• Lower energy than usual
• Fluid leaking from the ear
• Changes in hearing

These signs can provide clues, but they do not confirm an ear infection on their own. A red eardrum, for example, can also occur with fever or a viral upper respiratory infection. Diagnosis of acute otitis media involves both the child’s symptoms and an abnormal ear examination.

How does a GP check for an ear infection?

A GP can ask about your child’s symptoms, how long they have been unwell and whether they have recently had a cold or respiratory infection.

They can then examine the ear using an otoscope, a small instrument with a light and magnifying lens that allows the eardrum to be seen. The examination can help identify signs of inflammation or fluid behind the eardrum that may be consistent with a middle ear infection.

This is why an ear check can be useful when the symptoms are difficult to distinguish at home.

Does an ear infection always need antibiotics?

No. Many middle ear infections in children improve on their own, and antibiotics are not routinely needed in every case. Australian clinical guidance recommends avoiding routine antibiotic treatment for acute otitis media because many cases resolve without it.

Management depends on factors such as your child’s age, symptoms, examination findings, overall health and whether there is a higher risk of complications.

A GP may discuss supportive care and pain relief, or antibiotics when they are considered clinically appropriate. If symptoms do not improve as expected, further assessment may be recommended.

When should you have your child’s ears checked?

If your child has symptoms that could suggest an ear infection, such as ear pain, fluid from the ear, fever, vomiting, hearing changes or repeated ear infections, it is reasonable to discuss them with a GP.

Seek urgent medical care if there is redness, pain or swelling behind the ear, or if the ear appears to be pushed forward. These can be signs of mastoiditis, a rare but potentially serious complication of a middle ear infection.

For babies and very young children, symptoms can sometimes be difficult to interpret, so the overall picture matters. A GP can assess your child’s symptoms rather than relying on one sign such as ear tugging or fever.

When You’re Unsure, an Ear Check Can Help

Young children cannot always tell you where something hurts, and an ear infection may initially look much like an ordinary viral illness.

An examination can help a GP assess whether there are signs of a middle ear infection, consider other possible causes and discuss what care may be appropriate for your child.

An ear check can also be an opportunity to discuss your child’s broader health, including whether any routine health checks and screenings may be appropriate for their age and individual needs.

If you would like your child’s symptoms assessed, you can book an appointment with a GP consulting at HealthMint.

This blog provides general health information and does not replace personalised medical advice. Please consult a qualified healthcare professional. HealthMint complies with AHPRA advertising guidelines.