Can skin rash cause middle ear fluid accumulation?
Q: My 3.5 years old daughter is not allergic to any kind of food till date. She came in touch with the powder used on carrom boards and started itching and then broke out into hives and this recurred for a week. It would usually appear around evening and would only subside with a hydrocortisone ointment application and then Alerid or Atarax (Anti histamine) syrup. The doctor recommended Omnacortil forte and Alerid syrup for a week. During the same period, we realised that her hearing was not as before and got an audiometry test done, which showed that her hearing loss was approximately 46 % (both ears). The ENT specialist confirmed that she had fluid in both the ears and gave her antibiotics for a week. Now she has been put on Zyrcold syrup for a week. The doctor asked to come back in a few days and, in case the fluid is still present, we would need to do a myringotomy and probably an adenoidectomy too. The doctor suspect enlarged adenoids, but we have not taken any X-ray yet. Meanwhile, the hives subsided but she occasionally gets rashes. The doctor gave Laktrum powder, Ebast DT 5 mg and Nizonide oral suspension. We were told to not give her Zyrcold since she is taking the Ebast, but she has developed cough and cold since yesterday and now we are not sure what medications she can take. Will the Zyrcold affect the working of the Ebast? Can urticaria cause middle ear fluid? Is there any connection between the urticaria and the fluid in her middle ear?
A:1. The carrom board powder is very fine particles of boric acid. It can lead to an inflammation (allergy), when inhaled. The child has obviously come out of it, with treatment. Alerid, Ebast, Zyrcold and Ataraxc are all antihistamines. Based on their potency, other major effects, the tendency to cause drowsiness etc, the prescribing doctor selects one and gives you. When one is being taken, another may not be necessary. 2. Regarding the fluid in the middle ear, generally it will subside with treatment of cold or sore throat. Hence, a period of expectant waiting will be prudent. If it does not subside in a month or two, the fluid may have to be drained, by a procedure called myringotomy. This procedure is a routine procedure. However, every paediatric procedure requires general anaesthesia. Hence, some pre operative tests would be necessary.