Some Causes and Features of Ear Discharge
Cause |
Common Features* |
Diagnosis† |
Acute discharge (lasting less than 6 weeks) |
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Severe ear pain significantly relieved when a thick, whitish discharge starts |
A doctor's examination |
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Chronic otitis media (acute flare up) |
History of eardrum perforation and/or cholesteatoma (a noncancerous growth of skin cells in the middle ear), and previous discharge Eardrum appears abnormal during doctor's examination |
A doctor's examination Sometimes high-resolution temporal bone CT scan |
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Cerebrospinal fluid leak caused by severe head injury or recent neurosurgery |
Obvious recent head injury or neurosurgery Fluid ranges from crystal clear to blood |
Imaging studies such as head CT including skull base or MRI with gadolinium |
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Otitis externa (infectious or allergic) |
Infectious: Often after swimming or injury; severe pain, worse with pulling on ear Allergic: Often after use of ear drops; more itching and redness, and less pain than with infectious cause Typically a rash on the earlobe, where drops trickled out of ear canal Both: Ear canal very red, swollen, and filled with debris; eardrum appears normal |
A doctor's examination |
Chronic discharge (lasting more than 6 weeks) |
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Discharge often bloody, mild pain Sometimes doctor can see a growth in ear canal Typically in older people |
Removal and examination (biopsy) of ear tissue Usually CT or MRI |
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History of ear infections and typically eardrum perforation and/or cholesteatoma Less pain than with external otitis Eardrum appears abnormal during doctor's examination |
A doctor's examination Usually growth and examination of a sample of the ear discharge (culture) |
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Usually in children Drainage foul-smelling, pus-filled (purulent) Foreign object often visible during examination unless visibility blocked by swelling and/or discharge |
A doctor's examination |
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Often fever, history of untreated or unresolved otitis media Redness, tenderness over mastoid |
A doctor's examination Sometimes CT |
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Usually people have an immune deficiency or diabetes Chronic severe pain Swelling and tenderness around ear, abnormal tissue in ear canal Sometimes weakness of facial muscles on affected side |
CT or MRI |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. |
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† Although a doctor's examination is always done, it is only mentioned in this column if the diagnosis can sometimes be made only by the doctor's examination, without any testing. In other words, additional tests may not be needed. |
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CT = computed tomography; MRI = magnetic resonance imaging. |
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