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Purulent Labyrinthitis


Lawrence R. Lustig

, MD, Columbia University Medical Center and New York Presbyterian Hospital

Full review/revision Jun 2021 | Modified Sep 2022
Topic Resources

Purulent (suppurative) labyrinthitis is a bacterial infection of the inner ear that often causes deafness and loss of balance.

The Ears

The labyrinth is the bony cavity that contains the inner ear. The inner ear contains the organs of hearing (the cochlea) and of balance (see also Overview of the Inner Ear Overview of the Inner Ear The fluid-filled inner ear (labyrinth) is a complex structure consisting of two major parts: The organ of hearing (cochlea) The organ of balance (vestibular system) The cochlea and the vestibular... read more ). Purulent labyrinthitis usually occurs when bacteria enter the inner ear during the course of a severe infection of the middle ear (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 Otitis Media (Acute) ) or some forms of meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be... read more , or as a complication of a fracture of the temporal bone of the skull. It also may develop as a complication of a chronically perforated eardrum (as may occur in people who have repeated episodes of otitis media), particularly when people have a cholesteatoma (skinlike material that grows in the perforated eardrum).

Symptoms of Purulent Labyrinthitis

Diagnosis of Purulent Labyrinthitis

  • Computed tomography (CT) and/or magnetic resonance imaging (MRI)

  • Sometimes a spinal tap

Doctors suspect purulent labyrinthitis if people have vertigo, nystagmus, hearing loss, or a combination during an episode of acute otitis media. Doctors do a CT scan Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more Computed Tomography (CT) of the skull to look for abnormalities of the bone (temporal bone) that contains the inner and middle ear, the bones in the inner ear, and the bone behind the ear. Doctors may also do an MRI Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more Magnetic Resonance Imaging (MRI) to see if the infection extends into the brain.

Treatment of Purulent Labyrinthitis

  • Intravenous antibiotics

  • Drainage of fluid from the middle ear

Purulent labyrinthitis is treated with antibiotics given by vein (intravenously). Doctors also do a myringotomy, in which an opening is made through the eardrum to allow fluid to drain from the middle ear (see Myringotomy: Treating Recurring Ear Infections Myringotomy: Treating Recurring Ear Infections Myringotomy: Treating Recurring Ear Infections ). Some people may need a more extensive surgical procedure to remove all or part of the bone behind the ear (mastoidectomy).

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