 [ Symptoms ] what are the symptoms and signs of an ear infection in children [ Disease ] parents are relegated to determine if a child has a possible ear infection based solely on symptoms and signs [unless they have a home otoscope a tool that allows a look inside the ear and know how to use it] those of us in the clinical trenches know that symptoms and signs are not necessarily predictive of a definitive diagnosis a recent two year study in finland looked at 469 children ages 6 35 months and tested the predictive value of common middle ear infection symptoms ear rubbing or pulling irritability less playful excessive crying poor appetite restless sleep runny nose congestion vomiting diarrhea and fever the diagnosis of a middle ear infection otitis media requires a certain diagnostic criteria middle ear fluid detected by pneumatic otoscopy — this is the little bulb syringe attached to the otoscope that puffs air against the eardrum to check for mobility the normal in and out movement of the eardrum abnormal color opacity bulging shape of the eardrum middle ear infections are typically “bulging” and have a distinct red or yellow color instead of shiny white in this study not one but three different physicians systematically examined the ears of children strongly suspected by the parents as having a middle ear infection based on symptoms alone the results the duration and severity of the symptoms were not predictive of a middle ear infection ear rubbing and pulling long thought to be predictive of ear pain was proven to be an invalid sign it was actually more common in children who did not have a middle ear infection fever was also not a predictive sign a prior cold was not a predictive sign in this study although statistically most children who get middle ear infection usually do have a cold conjunctivitis pink eye may be a presumptive sign in some not all cases the only definitive way to diagnose a child with a middle ear infection is by a careful systematic medical examination by an experienced clinician using a pneumatic otoscope i see these false alarms nearly every day in my clinical practice parents believe their children have an ear infection when in reality they do not many parents will still demand antibiotics “just in case ” or come up with some compelling stories like going out of town tomorrow a seriously ill grandparent or upcoming air travel in an effort to plead their case cursory or incomplete examinations by hurried clinicians tend to over read ear examination findings resulting in inaccurate diagnoses i find this quite often in emergency room or urgent care visits here are 10 facts about ear infection 1 not all middle ear infections in children not including babies under the age of three months require antibiotics as a matter of fact over 90 percent of middle ear infections will self resolve in a few days… on their own without any medical intervention shocking it is perfectly fine to wait a few days to see if the body is immune