What is the real risk of ear infection turning into meningitis?

[LiLStar]

So ds.. poor baby, has first of all, a terrible diaper rash thats both yeast and staph. Tuesday night he started throwing up, has had a fever off and on, and been a pretty miserable  sick kid. A few spurts of happy/playful interspersed once in a while. Its only been maybe 2 hours or so since he last threw up so.. still going. We went to the ped today, and she found an ear infection as well. She suggested the possibility that its not just a tummy bug he has, but that the ear infection is severe enough that he has a fever and vomiting with it. The lack of diarreah in particular supported that theory. He's only had 3 poopy diapers since he got sick, but the last one DID look like diarreah. Is it still diarreah if its very watery but *infrequent*? (that one was after the ped visit) 

Anyway, she basically said it was a chicken/egg thing. We don't know if the ear infection was part of the package deal with a tummy bug, or if the vomiting and fever are symptoms of the ear infection. She wanted to give abx for it (especially since it'd be a 2 for 1 deal and knock out his diaper rash at the same time..and yes, we're doing nystatin and probiotics too!) because she said that an ear infection causing vomiting and fever has a 20% chance of turning to meningitis? Can that really be right? Its really hard to google anything about that because most results are about prevnar

[deditus]

No, I have never even heard that threat before. The excess fluid and congestion can cause dizziness and I would assume nausea hence the vomiting.My dd was a puker too when she had eis. I followed the wait and see approach before giving abx for the two eis my dd had. We were back at our hcp office for check-ups after 3 days, and both times they cleared up on their own.

[LiLStar]

hmm, interesting. The kid's a puker in general. Very spitty infant, and will throw up from about any illness. Common cold? He'll be gagging on post nasal drip first thing in the morning. Chicken pox? Threw up. His latest is separation anxiety (not on purpose) and not even just from crying hard. Sometimes he's not even crying. Just an all around pukey kid. He's been waking in the middle of the night to throw up. Could the dizzyness cause vomiting while he sleeps?

[Panserbjorne]

are you sure the concern wasn't mastoiditis instead of meningitis? 

[Jenivere]

When my son (almost 9) was little he twice got mastoiditis and the concern there was that could turn to meningitis. He had shown 0 symptoms of an ear infection, just one day developed redness behind one of his ears.  We treated with antibiotics because of the possibility for meningitis. Normally we would use oil and garlic for an ear infection but that was no longer an option.  While not a fan of frequent antibiotic use,  they  do have their place. And since you said there is staph involved I would definitely be using them. 

I did a google search with the term  "ear infection becoming meningitis" and got a lot of results like this one from Mayo clinic. http://www.mayoclinic.com/health/meningitis/DS00118/DSECTION=causes "Bacterial meningitis

Acute bacterial meningitis usually occurs when bacteria enter the bloodstream and migrate to the brain and spinal cord. But it can also occur when bacteria directly invade the meninges, as a result of an ear or sinus infection or a skull fracture."

 http://www.drgreene.com/azguide/meningitis

edited for spelling

[coyotemist]

Not sure on the %, I do know that many viral infections clear themselves up.  However, it's difficult to know if an infection is bacterial or viral, we always give it a bit and see if things change.  The bigger risk for us was the fact that for many months my son was deaf due to "glue ear", fluid that was stuck back there and never would drain out.  We tried many things, and nothing worked to get the fluid outt.  His speech is still impacted by that almost year.

He got tubes, so now we treat infections with antibiotic drops, and occasionally oral meds when that's not enough.  He's finally starting to talk.  Our solution to the ear infections actually is surprising to me...we stopped vaccinating.  About 7 months after the last vaccine he has his last ear infection, and it's been a year since he's had a shot and no infections since July, he's development has also reached a more typical range.

[sbgrace]

Is there a fever?

I *think* if an ear infection is going to go into meningitis (not the most common way for meningitis to occur at all) it would usually invade the mastoid bone first. My son had severe mastoiditis with an ear infection and my understanding at the time is that it is still relatively rare. He was hospitalized and on IV antibiotics. He needed surgery. He had an ear infection on a Sunday afternoon, seemed better on Monday afternoon into Tuesday (no fever, playing, etc). He spiked a high fever on Tuesday afternoon. He woke up on Wed. morning with his ear folded and bent forward to his face from the swelling. They did tell me it could develop into meningitis if not treated but no one was panicked as he was being treated.

My point...mastoiditis isn't anything close to 20% of ear infections and I believe it's the most common serious complication (it's still rare but increasing). I can't imagine her stats on meningitis are accurate.

If my other son got an ear infection I would use a wait and see approach and expect him to get better on his own within 48 hours before I did antibiotics. If mastoiditis boy got an ear infection I don't know what I'd do given his history. I guess I'd ask the ENT for advice re: wait and see vs. treat immediately. But I wouldn't be worried. The vast majority of ear infections are going to be fine left alone.

[LiLStar]

Yeah she didn't say 20% of ear infections, just 20% of ear infections with ds's symptoms (which may have been caused by a separate illness anyway) I'm not opposed to abx in this case.. particularly because it will treat two infections. ds, on the other hand, is HIGHLY opposed. *sigh* dh tried brute force, and then he threw up. I tried to sneak the syringe in while he was nursing in his sleep.. no. Tried some in chocolate pudding, and dh eventually got him to eat a few bites. But nowhere near a dose. I was going to try in a smoothie but he didn't nap today and is NOT in the mood. So.. maybe he'll drink that for breakfast tomorrow. He's being quite the stinker about it!

[sbgrace]

Hmmm...spotty antibiotics are worse than not doing it. I wonder if they could do an antibiotic shot given the vomit situation and trouble dosing? I'm thinking if the vomit stuff continues no matter how successful you are in dosing you're doing to be losing a lot of it.

You could try chocolate pudding on the spoon, dose, chocolate pudding.

Do you have bactroban cream for the staph?

[sbgrace]

Dr. Greene's site mentions:

Don't let other symptoms, such as loose stools or vomiting, throw you off the trail. Ear infections are sometimes accompanied by systemic symptoms.

http://www.drgreene.com/fact/fast-facts-about-ear-infections

I can't find any stats about it being an increased risk of movement and nothing I know about ear infections leads me to think it's the case. But you're right that you've got staph too and you've already started and so need to continue besides.

The antibiotics will make the yeast worse in most cases as you're killing off the good bacteria. Try probiotics yourself (if you're nursing) and also directly to the baby 3-6 hours after every antibiotic dose.

[LiLStar]

Yeah, I've been thinking of maybe asking if a suppository is possible. I'm cringing because.. ugh.. we paid $90 for that amox at a compounding pharmacy. (Yes, I can officially say.. I HATE artificial sweeteners to the tune of $90. My money is officially where my mouth is.) So its kind of a slap in the wallet for the kid to not even take it! Sigh. Regardless, its already spent and one way or another, we gotta get this kid healthy. If he rejects the smoothie tomorrow, I'll call the ped and ask for alternatives. 

Its kinda insulting that the ped would use what appears to be an unfounded scare tactic. She, and even the nurse, are sooo laid back about not vaxing. Don't even care. Very open minded about trying natural remedies, aren't quick to prescribe abx. I mean, did she think I'm so anti-med that I'd refuse unless she broke out the big guns or something? 

Oh.. and the vomiting has pretty much stopped. He did a little bit this morning, and the last one before that was when we stuck a syringe in his mouth last night. He is a little bit extra fussy still.