Meet the Children

Nakayla’s Preauricular Sinus Infection Part II

November 14, 2013

Continuing from my earlier post about Nakayla’s Preauricular Sinus Infection

The FIRST Follow-up:

It had been a few days since Nakayla started on the antibiotic course, but the infection in her ear don’t seem to be clearing at all. I was, naturally, worried.

We went down to the hospital about an hour earlier than the appointment time, thinking that we’ll be able to see the doctor at the appointed time, or earlier. In the end, we waited more than 30 minutes after our appointment time before we were called.

So while waiting, we took photos!

Her little teeth!

When we were finally called, Nakayla got checked, and I was asked by the ENT specialist if I wanted to admit Nakayla into the hospital that very night for surgery. Reason being, her ear infection don’t seem to be getting better, and we may as well admit her to undergo surgery to remove the swollen part. But she will be placed under general anaesthesia as they have to cut open the swollen infected part to let the area air dry on its own, and I have to return with her every single day, for at least 2-3 weeks, to get the wound cleaned.

Even though I was thinking she might have to go for it, I think my face kind of had a big fat ‘No’ on it. After an awkward silence, the ENT specialist offered another suggestion – maybe Nakayla could just continue with another week of antibiotics course. I didn’t know what to do, so I called Sean on the spot and had the ENT specialist talk to him. Sean, my knight in shiny armor, decided instantly. Nakayla was to have an extended course of antibiotics to get rid of the infection.

After that was decided, we made another appointment for a second follow-up, but not before the girl gets her milk before leaving.

The SECOND Follow-up:

The day did not start well for the second follow-up. I was having breakfast with my parents, and Nakayla was strapped onto me, when I felt something damp and warm near my thighs. I touched and looked down, only to find some poo leaking out from the sides of her diaper. Ever since she started on her antibiotic course, Nakayla’s poo has been little, but lethal. It somehow manages to find its way out of the diaper, despite how little there are!

But on this particular morning, it was explosive. I have photos of it, but I reckon it’s a little too gross for some people. If you need some description to give you a visual guide, here it is: It soiled half of her t-shirt, the sides of her shorts, my clothes, and the entire front of the baby carrier.

People around the coffee shop were staring, and I got a shock when I saw the full extent of it. I had removed her from the carrier to clean her up in my dad’s car (thinking it was just a tiny leak). My parents both got a shock too! And while I do have spare clothes for her to change into, I do not have enough wet wipes to clean up that kind of mess! So my dad drove us home to get washed up and changed before sending us to KKH.

We were a little late for our appointment, so we waited much longer for our turn. It was also terribly crowded!

Lucky for me, this girl is pretty easy to entertain for now. Just a biscuit and its wrapper can keep her occupied.

After seeing the ENT specialist (a different doctor from our first follow-up), I was told to let Nakayla finish up her current course of antibiotics before coming back for a third follow-up as her ear does seem to be better, which means the antibiotics are finally working.

While paying the bills, the little missy wanted her milk.

Drink, poop, sleep. Life of a baby is pretty nice sometimes.

The THIRD Follow-up:

The third follow-up was to ensure that her ear infection is indeed getting better, and to set a date for surgery to remove the ear pit track. As her ear pit has been infected once, the likelihood of it being infected again is really high. This was the one surgery that Sean and I were prepared to have Nakayla undergo, as I had read up about this particular infection prior to the first follow-up.

We reached a little more than an hour early. So early that the nurse told me that I was too early for my appointment and that I will have to wait a long time for my turn. After the last three visits, I was prepared to wait with Nakayla. However, in a strange twist of fate, within 10 minutes of waiting, we were called!

I was still busy taking photos when the nurse called for us. Haha!

The ENT specialist was the same doctor as the first follow-up, and he was very happy to see that Nakayla’s swelling ear pit looks much better. It’s still a little hard and red, but it has greatly reduced from the first time he saw it. He said we could proceed to schedule a date for surgery, but we have to return 2 weeks before for a pre-surgery check-up.

He informed me that it was a day surgery, a simple 30 minutes procedure, and that the wound from the surgery should all be healed in about 5 days.

It is highly recommended that we wait till Nakayla is above a year old before going for this procedure, but I was reminded not to delay it as there is a chance of re-infection.

So, the dates have been set. Nakayla will go for her pre-surgery check-up on Christmas eve, and her surgery will take place in the second week of 2014.

Will update further after the surgery. For now, I shall put the final pieces of her birthday party together! She’ll be turning one soon!

  1. Hi,

    I’m so glad to hear about your experience!

    My 16 month old daughter has 2 pits, one at each ear. She has gotten infection for 3 times, the last time being the worst. I consulted the ENT upon recommendation from the GP, who also advised to put her under GA to drain out the pus, at that time. Naturally I was frantic, my poor baby being put under GA! The thought of her under the GA was far more worrisome than the thought of the procedure itself.

    Went for second opinion at her PD. Dr actually punctured the swell and drained the pus. She said that would buy some time for me to decide if I want to remove the ear pit track. If not, she said, the infection would recur.

    Right now she has recovered fully, and I make sure I clean the pits well. Still not decided if we want to remove the pit tracks because I realise, after that, that many adult friends/colleagues actually have preauricular sinus too!

    1. Hi Shanice!

      Glad to know that your girl has recovered from the infection! As for undergoing GA to remove the ear pit tracks, I guess it’s individual preference.

      For my husband and me, we decided that just that little bit of GA to remove the ear pit track beats consuming the amount of antibiotics she took during the infection, which is bound to happen according to our ENT specialist. Pros and cons, I guess.

      We also kept Nakayla’s ear pit clean and dry, since the first sign of pus from her ear at about a month old. We clean it many times a day but it still swelled and got that badly infected after about 9-10 months on.

      Blake has the ear pit too, but we will be leaving his alone as there has been no infection. Hopefully, it will stay that way for him!

    1. Hi Rajesh, thanks for letting me know and all the best for the surgery! Looking forward to your update 🙂

  2. Hi

    My 4 year old daughter also has this pre-auricular sinus infection in her right ear. First infection was when she was 2 years old. We treated it with antibiotics. She gets infected 3 to 4 times in a year. ENT doctors suggesting me to remove the sinus track. But we are little worried about a surgery for our daughter. Is there any way to treat this without surgery? Is there any assurance that there won’t be any infections after surgery.? Anyone has any idea? Please update me !!!

    1. Hi Aneeta,

      From my knowledge, the surgery is to remove the track and close the hole. So I’m guessing no further infections will occur. But, it’s best that you seek the ENT specialist’s advice and ask them.

      So far for Nakayla, there has been no recurring infection, even though it looked like it might at one point. We’re still undecided with regards to the surgery, but if need be, we’ll go for it 🙂

  3. Hi Mabel,

    So glad to have found your site! My daughter is 9.5 months old and her ear pit got infected and it looked almost identical to your daughter’s infection the first couple of days. Her PD prescribed augmentin and warm compress. The swelling got bigger but the warm compress naturally popped the swelling that some pus came out. Not all of it but just a little. It looks better now but the swelling is still there.

    It is day 7 since it first got infected. How long did it take for your daughter to fully recover? Did her ear go back to normal looking and how long did it take? How long was she on the antibiotics? Did the doctor ever have to drain her ear?

    My PD told us to go to ER and get remaining pus drained on day 5 but ER doc didn’t want to do it because he didn’t think it was necessary. He just told us to schedule an appointment with an ENT, which will be next week (day 12 after start of infection).

    Sorry for the many questions and long comment but I am just very worried because I do not want the infection to spread. My baby hasn’t had any fever during this whole ordeal and you could never tell that she was sick if it wasn’t for the swelling in her ear. I think hearing about your daughter’s experience will ease my mind.

    Thanks a bunch!

    1. Hi Joon! I’ll be more than happy to share our experience with you 🙂

      We brought Nakayla to KKH’s A&E when the swelling got pretty bad – it was purple! She didn’t have fever whatsoever too. Perfectly fine if not for the infection, just like your girl. She was prescribed with augmentin as well, but we weren’t told to give warm compress. We were told to air it and keep it as clean and dry as possible.

      She took a total of 14 days worth of augmentin, with the swelling subsiding and disappearing towards the end. Her ear is completely normal now, but occasionally there are still pus coming out of it. We just make sure that her ear is always kept clean and dry. She hasn’t had another swelling + infection since!

      One of the doctors suggested to undergo surgery to seal up the hole, but before doing so, we had to put her under GA to remove all the pus. We decided not to go ahead with surgery after speaking to a number of doctors at KKH (from A&E to ENT). They reassured us that it’s not life threatening, nor will it affect her speech or hearing. Some of them have faced the same situation as Nakayla too! One of them did mention that we can always have it sealed when she’s much older and don’t require full GA – which is safer, in my opinion. So my husband and I decided to monitor her ear for a year before deciding if we should have her undergo the surgery. If the infection happens too many times and she has to take a lot of augmentin, we’d rather just have her undergo surgery to seal the hole up. Fortunately, Nakayla’s ear has been doing great!

      Visiting an ENT specialist will definitely set your mind at ease. They are trained and have extensive knowledge in this area. So it’s best that you go visit them. In the meantime, don’t worry too much!

      1. Hi Mabel,

        Thanks for the quick response! I really appreciate your sharing! My mind is at a little more ease knowing that your daughter’s ear healed completely without any draining. Our PD scared us by saying that the infection may spread if it doesn’t get drained but I figured that the body would naturally drain it. The last thing I would want to do is an unnecessary incision and drainage which would leave a scar. Thankfully, the ER doctor didn’t want to do it.

        Thanks again and I’ll pray that your daughter never gets infected again! God bless!

        1. You’re most welcome, Joon 🙂

          Did your PD say how it might spread? My understanding of the infection is that it will be contained in that area as it is just the ear pit track that’s affected – this will be what they will remove if we were to go for surgery to close the hole.

          Sending positive vibes and well wishes your way! Speedy recovery to your little girl and may it never get infected again! 😀

          1. She just said that she was worried that the infection might spread to the bone. When I did my research, the body fights the infection by isolating the bacteria and in the process, the cells of the body are “eaten” up as well. This ends up being the pus, which sometimes can get bigger if not properly handled. Small amounts of pus the body can naturally absorb but a large amount, it is difficult for the body to absorb, hence a drainage is needed. Warm compresses over the abcess help the pus come towards the skin and break naturally through the skin on its own. However, if the pus doesn’t drain naturally through the breaking of the skin or by a doctor making a small cut, there is the potential for the pus to go the other way towards the bone or other parts of the body. And when it does, there is a potential for the infection to spread. But I’m thinking that this is very rare. I think this is what the PD was concerned about.

            Ultimately though the antibiotics help the bacteria from spreading and so I think an infection spreading is only going to happen if no antibiotics is taken and the body is unable to contain it.

            But hopefully all of this info in the future won’t be necessary as both our little girls will never get infected again! Thanks again for the support and hope you have a good weekend with your family!

  4. Hi Mabel, my son still have pus coming every week after infection. How long does it take to get better. Does ur daughter have any discharge comes from her pit. Thank you

    1. Hi, I can’t quite remember how long it took before it cleared up completely for Nakayla, but I remember Nakayla had to go through two courses of antibiotics before it was okay. After the first course, there were still some discharge which was why she had to go through another course. I hope this helps!

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