What symptom is least likely to indicate an ear infection in children?

A skin rash is least likely to indicate an ear infection in children because it is not a typical symptom associated with otitis media or ear infections. Ear infections are primarily characterized by symptoms that directly relate to the ear or the child’s overall discomfort, such as pulling at the ears, which is a common instinctive behavior in children as they may be trying to alleviate the pain.

Irritability is also a common symptom because the discomfort caused by an ear infection can make a child fussy and more sensitive than usual. Difficulty sleeping is another frequent complaint, as lying down can exacerbate the pressure and pain associated with an ear infection, causing children to wake up more frequently or have trouble settling down for sleep.

In contrast, a skin rash could arise from a variety of conditions, such as allergic reactions or viral illnesses, and does not typically correlate with problems in the ear. This makes a skin rash an unrelated symptom, whereas the other options are directly linked to the experience of an ear infection.