*

*A child with an ear problem may have an ear

infection.
*When a child has an ear infection, pus
collection behind the eardrum and causes pain
and often fever
*If the infection is not treated, the eardrum may
burst.
*The pus then discharges, and the child feels less
pain.
*Fever and pain may stop, but the child suffers
from poor hearing because eardrum has a hole
in it.
*Usually the eardrum heals by itself. At
other times, the discharge continues, the
eardrum does not heal, and the child
becomes deaf in that ear.
*Sometimes, the infection can spread from
the ear to the bone behind the ear (the
mastoid), causing mastoiditis.
*The infection can also spread from the
ear to the brain, causing meningitis.
*Ear infections rarely cause
death.
*Ear infections are the main
cause of deafness in developing
countries, and deafness causing
learning problems in school.
*A child with an ear problem is
assessed for:
*Ear pain
*Ear discharge
*If discharge is present, how long
the child has had discharge
*Tender swelling behind the ear (
a sign of mastoiditis)

*
*Is there ear *Look for pus
pain? draining from
the ear.
*Is there ear
discharge? *Feel for
tender
*If yes, for how
long has there
swelling
been such? behind the
ear.
*
*ASK: Does the child have an ear
problem?
*If the mother answers NO, record her
answer. Do not assess the child for ear
problems. Go to the next question, and
check for malnutrition and anemia. If
the mother answers YES, ask the next
question.

*
*If the child has ear pain, it can mean that the child
has an ear infection.

*ASK: Is there ear discharge? If yes, for how long has

the child had it?
*Ear discharge is also a sign of infection.
When
asking about the ear discharge, use words the
mother will understand. If the child has ear
discharge, ask his or her mother for how long the
child has had it.

*
*An ear discharge that has been present
for 2 weeks or more should be treated as
a chronic ear infection.
*An ear discharge that haws been present
for less than 2 weeks should be treated as
an acute ear infection.

*
*Pus draining from the ear is a sign of infection,
even if the child no longer has any pain. Look
inside the child’s ear to see if pus is draining
from the ear.
*FEEL for tenderness swelling behind the ear.
*Feel behind both ears. Compare them and
decide if there is tender swelling of the
mastoid bone. In infants, the swelling may be
above the ear.

*
*Both tenderness and swelling
must be present to classify the
child as having mastoiditis, a
deep infection in the mastoid
bone. Do not confuse this
swelling of the bone with
swollen lymph nodes.
*There are four classifications of
ear problems namely:
*MASTOIDITIS
*ACUTE EAR INFECTION
*CHRONIC EAR INFECTION
*NO EAR INFECTION
*
 SIGNS CLASSIFY AS TREATMENT
*Tender swelling behind MASTOIDITIS *Give the 1st dose of an
the ear appropriate antibiotic
*Give the 1st dose of
paracetamol fr pain.
*Refer the child URGENTLY to a
hospital
*Pus draining from the ACUTE EAR *Give antibiotic for 5 days
ear, and discharge that INFECTION *Give paracetamol for pain.
has been present for *Dry the ear by wicking.
less than 14 days, or *Follow up in 5 days.
*Ear pain
*Pus draining from the CHRONIC EAR *Dry the ear by wicking.
ear, and discharge that INFECTION *Follow up in 5 days.
has been present for 14
days or more
*No ear pain and pus NO EAR *No additional treatment
seen draining from the INFECTION
ear
*If the child has tender swelling behind the
ear, classify the child as having
MASTOIDITIS.

Treatment:
- Refer the child urgently to a hospital. This
child needs treatment with injectable
antibiotics. He may also need surgery.
Before the child leaves for the hospital, give
him or her the first dose of an appropriate
antibiotic. Also, give one dose of
paracetamol if the child is in pain.

*
*If you see pus draining from the ear, and discharge has
been present for less than two weeks, or if there is ear
pain, classify the child’s illness as ACUTE EAR
INFECTION.

*Treatment:
*Give a child with ACUTE EAR INFECTION an
appropriate antibiotic. Antibiotics for treating
pneumonia are effective against the bacteria that
cause most ear infections give paracetamol to relieve
the ear pain (or high fever). If pus is draining from
the ear, dry the ear by wicking.

*
*If you see pus draining from the ear, and
discharge has been present for two weeks or
more, classify the child’s illness as CHRONIC
EAR INFECTION
*Treatment:
*Most bacteria that cause CHRONIC EAR
INFECTION are different from those that
cause acute ear infections. For this reason,
oral antibiotics are not usually effective
against chronic infections.
*
*If there is no ear pain and
no pus is seen draining from
the ear, the child is
classified as having NO EAR
INFECTION. The child needs
no additional treatment.