Some Causes and Features of Ear Discharge
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 |
Doctor’s examination alone |
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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 |
Sometimes doctor’s examination alone 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 discharge trickled out of ear canal Both: Ear canal very red, swollen, and filled with debris; eardrum appears normal |
Doctor’s examination alone |
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 |
Sometimes doctor’s examination alone Usually culture of a sample of the ear discharge If suspected cholesteatoma, MRI |
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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 |
Doctor’s examination alone |
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Often fever, history of untreated or unresolved otitis media Redness, tenderness over mastoid |
Sometimes doctor’s examination alone 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 Usually culture |
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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 mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing. |
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CT = computed tomography; MRI = magnetic resonance imaging. |
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