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Ask Dr. Y. Vasavada Your Own Question
Dr. Y. Vasavada
Dr. Y. Vasavada, Pediatrician
Category: Paediatrics
Satisfied Customers: 3309
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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Hi, we are currently on vacation on a remote island in Indonesia,

Customer Question

Hi, we are currently on vacation on a remote island in Indonesia, with limited access to doctors. Saturday night my 5 year old started complaining of a pain in his right ear. Not IN the ear, but just inside the outside of the ear. He was in a lot of pain and would not let us touch it. We looked carefully but could not see anything. I cleaned the area gently with a swab and iodine, and put him to bed with some paracetamol.

The next morning he was crying from the pain, and had a fever. His lymph nodes on the right side of his neck were swollen and painful. He complained of a sore throat and a head ache. He had a runny nose. His tongue was whitish with tiny red dots visible. We had a nurse come (this was all that was available) and look into his ear, as we suspected an ear infection. However the nurse said that the ear was not red on the inside. We gave him paracetamol every 6 hours to control the high fever and pain (he was often in tears and would not let us go near his right ear or right side). We also gave him probiotics and vitamin C and tried to keep his fluid intake up.

Last night (Sunday night) he slept in spurts, waking every half hour crying in pain. This morning he is also crying in pain and has a fever (37.7 so not huge). He says the pain is still on the outside of his ear. His lymph nodes are still swollen. He still has a slightly congested nose and a sore throat. Usually when he is sick he just sleeps a lot, we have never seen him in so much pain.

We are trying to get a doctor here, but in the meantime would like your advice...Should we consider emergency evacuation? Are there any more sinister things this could be (e.g.: meningitis, etc...). Should we give him antibiotics? The nurse was proposing amoxycillin, however I am always loathe to give antibiotics so soon and without a proper diagnosis.

Thank you so much.
Submitted: 3 years ago.
Category: Paediatrics
Expert:  Dr. Y. Vasavada replied 3 years ago.

Dr. Yogindra Vasavada :

Hello, Sorry about this illness. One sided painful ear with fever (and viral sore throat) makes use of antibiotic justified. Please use Amoxy or Azithro and see for a day, otherwise approaching an ENT specialist may be considered. Paracetamol can safely be given every 4 hours and additionally advil (Ibuprofen) may help relieve swelling.

Dr. Yogindra Vasavada :

Please make him gargle throat (face raised) using warm salt water. In his milk glass you may add small pinch of dry turmeric powder or use green turmeric root juice with honey.

JACUSTOMER-j2jxfzte- :

Thanks. It turns out he has otitis externa, so he is having antibiotic drops into the ear. No systemic antibiotics are necessary, or advised.

Dr. Yogindra Vasavada :

Good for him. Easy to diagnose when ear drum was inspected. With lymph node enlargement and fever, local antibiotic may not suffice. Please observe for day or so.