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) | ||
| Acute otitis media Otitis Media (Acute) Acute otitis media is a bacterial or viral infection of the middle ear. Acute otitis media often occurs in people with a cold or allergies. The infected ear is painful. Doctors examine the eardrum... read more | Severe ear pain significantly relieved when a thick, whitish discharge starts | Doctor’s examination alone |
| 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 | |
| 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 |
| 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) | ||
| 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 | |
| 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 | |
| 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 | |
| Often fever, history of untreated or unresolved otitis media Redness, tenderness over mastoid | Sometimes doctor’s examination alone Sometimes CT | |
| 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 | |
| * Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
| † 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. | ||
| CT = computed tomography; MRI = magnetic resonance imaging. | ||
