Merck Manual

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Purulent Labyrinthitis

(Suppurative Labyrinthitis)

By

Mickie Hamiter

, MD, New York Presbyterian Columbia

Reviewed/Revised May 2023
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Purulent labyrinthitis is a bacterial infection of the inner ear that often causes deafness and loss of balance.

The Ears
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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. Chronic infection of the middle ear or a cholesteatoma increases the risk of purulent labyrinthitis.

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 this procedure, 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 ). Sometimes tympanostomy Treatment 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 Treatment is done. For this procedure, tubes are placed through a cut made in the eardrum so that fluid can drain out of the middle ear. 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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