[livi]

Right. There are several parts and aspects of this situation. The specific ear drum issue is not my area so I won´t comment on that.

First, the longer periods of cough and fever is probably attributed to the compact impact of virus and bacteria that children are facing daily. Each individual immune system will react more or less vigilant to any given amount and type of bug. The cough may be an asthmatic reaction to all these bugs, as well as the fever. I suspect thats why you got the nebulizer. What drugs where you prescribed? I would go for a daily dose of inhaled steroid, like for example Budesonide 200-400ug daily for about a month to see if it make any difference in the coughing. If that did not help (and perhaps simultaneously) I would give him a prolonged period of macrolide (for ex. Erythromycin) antibiotics - maybe 2-4 weeks.

Next, the adenoid tissue. Its rather common for preschool children to have an unnecessarily large adenoid tissue behind the nose. This will often lead to various problems related to breathing, congestion and such. As it is immunologically very active tissue, much like the tonsils, it may also contribute to the immune systems response to all these, previously mentioned, bugs. Hence it may also contribute to fever reactions and cough.

This was the short version, but in summary, I would recommend removing the adenoid. It is a routine procedure, low risk, with good chances of improvement on several levels.

Best of luck and please PM me if you have any other or related questions!