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Forum Name: Pediatric Topics

Question: Urgent:swelling of child's helix


 shantell - Thu Jun 19, 2003 1:52 am

Hello,
I brought my 5 year old son into the emergency room on june 14th because his ear was badly swollen, the helix. One ear is badly swollen the other is starting to swell.
They told me he had an allergic reaction, and gave me what i thought was a prescription, which in fact it was some allergy benardryl that you could buy over the counter.
Its been 5 days since i brought him to the hospital. I thought his ear was starting to go down, but tonight it actually started to swell a little more.
It looks as if there is blood in his swollen part of his ear, which by searching online i found it to be his helix.
Could someone please help me, and let me know what i should do. I plan on bringing him to a pediatrician in the morning, but i am worried sick.

Thanks, Shantell
 Dr. Russell M - Thu Jun 19, 2003 2:11 am

User avatar Hi!

Does he have fever/itching/discharge or history of any other diseases in the family? [/quote]
 shantell - Thu Jun 19, 2003 2:30 am

No, when i brought him in he had a temp of 98degrees, he has no fever now. And there is no history of any diseases or anything like that. No discharge, itching, etc... Just badly swollen with what looks like blood. On the whole upper rim of his ear, and the other ear is slightly swollen. The same as when i brought him into the emergency room, that ear hasnt changed. Just the badly swollen ear has swelled more.
 Dr. Russell M - Thu Jun 19, 2003 3:27 am

User avatar Hi!

From your description, I feel if the there is some fluid (pus/blood) swelling up the ears, it needs drainage. I would suggest seeking the help of an ENT surgeon/Head & Neck surgeon for expert help.

But if, as was considered earlier as allergic, the causes could be plenty and management accordingly with avoidance of the triggering allergen.

Is there any history of trauma to the ears/head? Sunlight could be a factor that triggers inflammation of the skin when combined with topical or ingested agents that interact with proteins of skin or absorb UV radiation. There is a condition called JSE, or Juvenile Spring Eruption of the ears, but like allergy, pruritus/itching is usually there, and I don't know if its spring in Louisiana.

Juvenile spring eruption of the ears (JSE), a photodermatosis (skin affected by light), primarily affects boys aged 5-12 years. This disorder typically appears in the spring following the first intense sun exposure and may persist through the summer. Often, a history of JSE in other family members, typically fathers and brothers, suggests a familial predisposition. Although the prevalence is higher in boys, girls also may be affected. However, girls' ears often are protected from the sun by their hair.

Triggered by sunlight or a combination of sunlight and cold air, JSE presents as pruritic, erythematous, circumscribed solid elevations (papules) that progress to small (<0.5 cm) fluid-filled lesions (vesicles) or even blisterlike lesions (bullae). Within 1-2 weeks, the vesicles crust over and heal with minimal or no scarring.

But I am hopeful that from your description the disease should be amenable to treatment and you would provide feedback after a visit to your doctor.
 shantell - Thu Jun 19, 2003 12:15 pm

I am off to the doctor, i will give you feedback on what the doctor has said.
See there is no itching. And the other ear has started to swell as well. But of course not as much.
There is no history of JSE in my family. And he has no brothers. He does have short hair, and likes to wear a cap exposing his ears.
His daddy and him like to go frogging at night, so he does spray some repelent on him, but he has always done that and no problems arose before.
It is spring here now, summer is a few days away.
The day before my son's ear started to swell, his daddy did put some kind of sealant on the bottom of his metal canoe. I am wondering if that could be the cause. But wouldnt you think that with the allergy benadryl he has been taking, that the ears would start to go down, instead of actually worsening. If it was an allergic reaction.

I will be back to let you know what the doctor has said.
Thanks so much, you have lightened my load alot by helping me.
Thanks, Shantell
 shantell - Thu Jun 19, 2003 3:25 pm

Hello,
Well i have brought my son christian to the doctor. He said that it is definately not a allergic reaction. He said that he has either pus/blood in his ear, it is a bacteria infection. Maybe caused by a insect bite. He said that if it was an allergic reaction the area would not have fever in it and he would have it elsewhere besides his ears.
He prescribed some Sulfatrim 200-40/5 Sus Alph, to him. He said that after one day for me to bring him into an ear specialist if i don't see any improvement.
The generic name of his medicine is: Sulfamethoxazale and Trimethoprim.
But his prescription name is: Sulfatrim. He has to take it every 12 hours for 1 week.
I did tell the doctor of JSE, but he said he wasnt familiar with it. Also he said he would normally like to drain the ear in his office, but since he was so small and since it was in the face region, he wasnt going to do that.

Thank you so much for giving me feedback on what you think the cause might be. It was very helpful in me getting some sleep last night. And i really appreciate it!!.

Bye, Shantell
 Dr. Russell M - Fri Jun 20, 2003 6:33 am

User avatar Hi!

Good to know that your son is receiving the right antibiotic, though, if painful and swollen, I would add an analgesic antiinflammatory drug along with the antibiotic, and apply dressing with some glycerine magsulfate to the swollen external [not internal] ear so as to let some of the fluid in the swelling get absorbed out. One of the best antibiotics, sulfa antibiotics are notorious for their propensity to cause serious reactions in patients who are already allergic to the drug, which I hope your son is not.

The pleasure remains mine to have found myself helping others...
 shantell - Sat Jun 21, 2003 2:00 pm

Bill,
What is glycerine magsulfate, and where can i find it?. I would like to get some and apply it to his ear. Since his ear has not budged. It is still Massively swollen. I was thinking of taking him to the hospital and having them drain it. But i don't know they would do it. Since even the doctor didnt want to since he is so small and the swelling is so close to the face region.
I don't think he is allergic to the medicine. He has taken it 4 times so far, and has not showed any reaction to it. Thank Goodness!!.
If you could let me know about the glycerine magsulfate, and can i buy the analgesic antiinflammatory drug over the counter?. It would be appreciated!!.
Thank You,
Shantell
 shantell - Sun Jun 22, 2003 1:49 am

Hello,
Well i ended up bringing my son back up to the hospital today. Because his ears were swelling and i was worried. So i wanted to get them drained. I didnt know what would happen if they erupted.
The Doctor spoke with me and i told him i wanted to possibly drain his ears. The Doctor thought he should. So they gave him a shot of pain medicine. Then they numbed his ear and drained his massively swollen ear into a needle holder. They said they would send it off to the lab to find out if it was infact infected. They then made a little cut line and got out all of the blood/fluid from his ear. They then had to do the same to the other ear.
I had been talking with the Doctor about all the posibilities of what it could have been that caused this massive swelling in one of his ears and the progression of the other ear as well. And i had mentioned that he wore a ball cap and wore it so tight everyday that his ears were forceably flapping forward. The Doctor thinks that possibly, his hat being so tight and forcing his ears down could have possibly broke some blood vessels and then the ears could have been building up with calcuim, blood, fluid. So that is the conclusion he has come up with. And he said it was hematoma. But my son was also around his father when he fiberglassed a boat with some sealant. So i don't know what the true cause of his ears to swell like that is!.
The Doctor is keeping him on the antibiotic til the results come back from the lab.
They dressed his ears and head and he has to wear the dressing for 3 days. The Doctor said that it might try to swell up again and if it does to come back in so they can drain them again.
So that is it.
Thanks so much for all your help bill!!!.
Bye, Shantell
 Dr. Safaa Mahmoud - Sun Jun 22, 2003 4:15 am

User avatar Dear shantel,
Good luck for your child, keep an eye on his temperature and keep us posted.
Thank you
 shantell - Tue Jul 08, 2003 3:17 am

Hello,

Ok, this is the update on my son Christian.
Well i ended up having to bring him to the hospital again to have his ear drained. The swelling would not go down. The antibiotics werent working. His ear was swelling massively and starting to hurt him real bad. So they drained it a second time.
The ER referred me to a Ear,Throat and Nose specialist. Because they were concerned with a deformity of the ear, that my son was starting to develop from the drainage and swelling of his ear.
I went to the Ear Specialist office on June 30th. His Doctor said he would have to go into surgery that night. That what he infact had was Auricular Hematoma {Califlower ear}.
His Doctor said that since the other doctors had just cut his ear a tiny bit, that it just kept building up pressure, and blood is what was filling his ear up.
He went into surgery that night. They had to put him to sleep for the surgery. The surgery only lasted about 15 minutes. They cut his ear along the whole top rim of his helix, then sowed on a flattening thingy onto both sides of the ear. So that his ear would flatten out. Then they placed a cup on the side of his head.
I had to put some Bacitracin Zinc Ointment on his ear 3 times a day. And they prescribed him an antibiotic called Augmenten ES 600mg
He went back to the doctor today {1week after surgery}. The doctor took off the stitchings and it looks better, just a tiny bit swollen and a tiny bit red.
But he has to finish off his 10 supply of Augmenten.
And he has to go back in another week.
The Doctor said that he will most probaly have a deformity of the ear, that it will not look like the other ear, but there is a chance of it healing completely.
I have to go back in one week from today {Monday}. I will update ya'll after i go.
Thank You,
Shantell

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