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Ear pain and discharge


Ear - Discharge

Is this your child's symptom?

  • Drainage of substance or liquid from the ear canal
  • Drainage through an ear tube is included

Types of Ear Discharge

  • Pus or Cloudy Fluid. This is the most common type of ear discharge. The main cause is an ear infection. The drainage is from a torn eardrum. The eardrum ruptures in about 10% of bacterial ear infections.
  • Ear Tube Fluid Release. Children with frequent ear infections may get ventilation tubes put in. These help the middle ear drain its fluids and become dry. Sometimes, the ear tube gets plugged up. Normal fluids build up in the middle ear until the ear tube opens up again. This can cause some clear fluid drainage from the ear canal for a day.
  • Earwax. Earwax is light brown, dark brown, or orange brown in color. If it gets wet, it can look like a discharge.
  • Blood. This follows an injury to the ear. Usually, it's just a minor scratch of the lining of the ear canal.
  • Water. Bath water or tears can get in the ear canal. Seeing a clear "discharge" that happens once is likely this.
  • Ear Drops. The person who sees the discharge may not know someone else put in drops.
  • Swimmer's Ear Discharge. Early symptoms are an itchy ear canal. Later symptoms include a whitish, watery discharge. Mainly occurs in swimmers and in the summer time.
  • Ear Canal Foreign Object. Young children may put small objects in their ear canal. It can cause a low grade infection and pus colored discharge. If the object was sharp, the discharge may have streaks of blood.

When to Call for Ear - Discharge

Call Doctor or Seek Care Now

  • Pink or red swelling behind the ear
  • Clear or bloody fluid after a head injury
  • Bleeding from the ear canal. Exception: few drops and after an ear exam.
  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Age less than 6 months old
  • Ear pain or crying like in pain
  • Discharge is yellow or green, cloudy white or smells bad
  • Clear drainage (not from a head injury) lasts more than 24 hours
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Normal earwax or other harmless discharge

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

Care Advice for Ear Discharge

  1. Earwax:
    • Ear wax protects the lining of the ear canal and has germ-killing properties.
    • If the earwax is removed, the ear canals become itchy.
    • Do not use cotton swabs (Q-tips) in your child's ear.
    • Call Your Doctor If: begins to look like pus (yellow or green discharge).
  2. Clear Discharge (without head injury):
    • Most likely, this is from tears or water that entered the ear canal. This can happen during a bath, shower, swimming or water fight.
    • Don't overlook eardrops your child or someone else used without telling you.
    • In children with ventilation tubes, some clear or slightly cloudy fluid can occur. This happens when a tube blockage opens up and drains.
    • Call Your Doctor If: clear drainage lasts for more than 24 hours.
  3. Blood After Ear Exam:
    • Sometimes, ear wax needs to be removed by your doctor to see the eardrum. If ear wax was removed, it can cause a small scratch inside the ear canal. This happens about 10% of the time. The scratch oozes 1 or 2 drops of blood and then clots.
    • This should heal up in a few days.
    • It shouldn't affect the hearing.
    • Don't put anything in the ear canal. This may start the bleeding again.
    • Call Your Doctor If: bleeding starts again.
  4. Cloudy Discharge - Ear Infection:
    • Cloudy fluid or pus draining from the ear canal usually means there's an ear infection.
    • The pus drains because there's a small tear in the eardrum.
    • To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed.
    • See Earache care guide for more advice.
  5. Call Your Doctor If: Your child becomes worse.

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/07/2022

Last Revised: 01/13/2022

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.

Ear Discharge: Causes, Treatments, and Prevention

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Overview

Ear discharge, also known as otorrhea, is any fluid that comes from the ear.

Most of the time, your ears discharge earwax. This is an oil that your body naturally produces. The job of earwax is to make sure that dust, bacteria, and other foreign bodies don’t get into your ear.

However, other conditions, such as a ruptured eardrum, can cause blood or other fluids to drain from your ear. This kind of discharge is a sign that your ear has been injured or infected and requires medical attention.

In most cases, discharge from your ear is simply ear wax making its way out of your body. This is natural. Other conditions that can cause discharge include infection or injury.

Middle ear infection

Middle ear infection (otitis media) is a common cause of discharge from the ear. Otitis media occurs when bacteria or viruses make their way into the middle ear. The middle ear is behind the eardrum. It contains three bones called ossicles. These are vital to hearing.

Ear infections in the middle ear can cause fluid to build up behind the eardrum. If there is too much fluid, there is a risk of perforation of the eardrum, which can lead to ear discharge.

Trauma

Trauma to the ear canal can also cause discharge. Such trauma can occur while cleaning your ear with a cotton swab if you push it in too deep.

An increase in pressure, such as when you’re flying in an airplane or scuba diving, can also result in trauma to your ear. These situations may also cause your eardrum to rupture or tear.

Acoustic trauma is damage to the ear due to extremely loud noises. Acoustic trauma can cause your eardrum to rupture as well. However, these cases aren’t as common as the others described.

Swimmer’s ear

Otitis externa, commonly known as swimmer’s ear, occurs when bacteria or fungus infects your ear canal. It usually occurs when you spend long periods of time in water.

Too much moisture inside your ear can break down the skin on the walls of your ear canal. This allows bacteria or fungus to enter and cause an infection.

However, swimmer’s ear isn’t exclusive to swimmers. It can result whenever there’s a break in the skin of the ear canal. This might occur if you have irritated skin as a result of eczema.

It can also occur if you insert a foreign object into the ear. Any damage to your ear canal makes it more susceptible to infection.

Less common causes

A less common cause for ear discharge ismalignant otitis externa, a complication of swimmer’s ear that causes damage to the cartilage and bones in the base of the skull.

Other rare causes include a skull fracture, which is a break in any of the bones in the skull, or mastoiditis, which is an infection of the mastoid bone behind your ear.

You should call your doctor if the discharge from your ear is white, yellow, or bloody or if you’ve had discharge for more than five days. Sometimes ear discharge may occur with other symptoms, such as a fever. Tell your doctor if you have any accompanying symptoms.

If you experience serious pain, your ear is swollen or red, or you have a loss of hearing, you should see your doctor.

If you have an injury to the ear that causes discharge, that’s another good reason to consult a doctor.

You can connect with an ENT in your area using the Healthline FindCare tool.

Treatment of your ear discharge depends on its cause. In some cases, your condition won’t need medical treatment.

For example, the American Academy of Pediatrics describes a 48-hour “wait-and-see” approach, accompanied by close follow-up, as one option for treating mild ear pain in children.

Signs of an ear infection usually start to clear up within the first week or two, without any treatment. Pain medications might be needed to deal with any pain or discomfort.

If your child is under six months old or has a fever over 102.2°F, your doctor might prescribe antibiotic ear drops.

Most cases of ear trauma also heal without treatment. If you have a tear in your eardrum that doesn’t heal naturally, your doctor might apply a special paper patch to the tear. This patch keeps the hole closed while your eardrum heals.

If a patch doesn’t work, your doctor might surgically repair your ear using a patch of your own skin.

A doctor should treat swimmer’s ear to prevent the infection from spreading. Typically, your doctor will give you antibiotic ear drops to use for about a week. In severe cases, oral antibiotics will also be necessary.

To avoid ear infections, try to stay away from people who are sick.

According to the Mayo Clinic, breastfeeding may provide infants with protection from ear infections, since they receive their mother’s antibodies in their milk.

They advise that, if you bottle-feed your baby, you should try holding your infant in an upright position rather than letting them drink lying down.

Keep foreign objects out of your ears to avoid rupturing your eardrum. If you know you’ll be in an area with excessive noise, bring ear plugs or muffs to protect your eardrums.

You can prevent swimmer’s ear by making sure to dry your ears after being in the water. Also, try to drain any water by turning your head to one side and then the other. You can also use over-the-counter medicated ear drops after you swim to control and alleviate swimmer’s ear.

Shop for over-the-counter ear drops online.

Shop for ear plugs or muffs online.

Discharge from the ear or otorrhea

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IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Discharge from the ear: causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment.

Definition

Earwax is a physiological secretion from the ear canal and protects the hearing aid from pathogenic bacteria. It consists of fat, fatty acids and fat-like substances, as well as various mineral salts. Normally, a person produces 15–20 mg of earwax during the month, which looks like a sticky yellow-brown mass. All other discharges are considered pathological and indicate ear diseases.

Types of discharge from the ear

The discharge may be transparent, white, light or dark yellow, greenish (in the presence of pus). If blood enters the ear secretion, the discharge becomes reddish or brownish in color.

The discharge may be watery in consistency, have a cheesy or flaky texture, and may sometimes form crusts.

An unpleasant smell of discharge due to the presence of pus in them can serve as a diagnostic sign.

What diseases and conditions cause discharge from the ear

Sulfur plugs . Excessive work of the sulfur glands leads to the formation of a sulfur plug. Most often, this problem occurs in patients with diabetes mellitus, metabolic syndrome, high cholesterol levels in the blood. The formation of sulfur plugs provokes an increased viscosity of sulfur, dry skin, small foreign particles (for example, industrial dust) entering the ear, as well as excessive hair growth in the ear canal. Often, sulfur plugs are observed in people involved in water sports, using hearing aids, miniature headphones.

With improper hygiene measures and independent attempts to remove excess earwax, there is a risk of pushing it deeper into the ear canal, thereby causing a plug to form.

Clinical signs of sulfur plug are pain and stuffiness of the ear, tinnitus, especially painful when sulfur comes into contact with the eardrum, sometimes headache, dizziness, nausea.

Mucopurulent and purulent discharge is a symptom of inflammation of the outer and middle ear. In inflammation external ear (otitis externa) pathological process can develop in the auricle and external auditory canal (up to the tympanic membrane). Most often, external otitis occurs against the background of infection of the ear with bacteria and microscopic fungi. Its first signs are, as a rule, pain in the ear, itching, less often - hearing loss and a feeling of fullness. Mucopurulent discharge appears only with a common form of the inflammatory process throughout the auditory canal.

The source of purulent discharge in the outer ear can also be a boil located in the shell or ear canal. With otitis media, mucopurulent and purulent discharge results from infection of sterile effusion from inflamed ear tissues. Since the chamber of the middle ear is closed by the tympanic membrane, purulent discharge may appear in the outer ear only after the formation of a hole in it. This is preceded by severe pain in the ear, fever, hearing loss, and in children - overexcitation, sometimes vomiting.

When mastoiditis (inflammatory lesion of the mastoid process of the temporal bone), purulent discharge from the ear also appears. As a rule, this disease develops as a complication of otitis media and is accompanied by fever, soreness and swelling in the mastoid process behind the ear.

Clear, bloody or purulent discharge occurs with acute infectious myringitis (inflammation of the eardrum), which may be of fungal or bacterial origin. Bubbles filled with blood form on the surface of the eardrum, which then burst. In addition to discharge, ear congestion is observed.

Transparent, colorless or slightly pinkish discharge from the ear may be the result of liquorrhea - the outflow of cerebrospinal fluid. It enters the auricle in case of skull fractures (usually temporal) due to trauma.

In addition, transparent watery discharge sometimes accompanies allergic otitis , which is also characterized by other signs - itching, ear congestion.

Unaltered blood appears from the ear, usually after injury and rupture of the eardrum .

Such an injury can be caused by acoustic and mechanical shocks, as well as due to improper hygiene procedures. A ruptured eardrum is always accompanied by severe pain.

The appearance of bloody-purulent discharge from the ear is one of the evidences of the presence of a polyp on the tympanic membrane or mucous membrane of the middle ear . A polyp is an overgrowth of tissue in response to its irritation. The appearance of a polyp is preceded by active inflammation of the middle ear. In addition, polyps can be the result of myringitis, otitis externa, malignant neoplasms. Perforating the tympanic membrane, the polyp can protrude into the area of ​​​​the external auditory canal, leading to hearing loss.

Insignificant secretions, sometimes forming crusts and having an unpleasant odor, are characteristic of cholesteatoma - a tumor-like formation formed from the epidermis of the ear canal. In most cases, cholesteatoma complicates chronic purulent epitympanitis and is formed from layers of keratinized epidermis, water, proteins, fats and cholesterol. The formation of cholesteatoma is accompanied by feelings of heaviness and fullness in the ear, headache. If left untreated, it can gradually invade the mastoid process and the cranial cavity.

At otomycosis loose curdled discharge is observed. The main culprits of the disease are molds (often localized in the outer ear) and yeast-like fungi (more often inhabiting the middle ear). Clinical signs of otitis externa in these cases include pain and colored cheesy-necrotic discharge from the ear. Patients complain of tinnitus and dizziness.

Discharge that contains large, fatty flakes, sometimes mixed with pus, is characteristic of seborrheic ear dermatitis . The disease can affect not only the ear, but also the scalp. Clinical signs are severe itching, swelling of the auricle, peeling of the skin and weeping wounds.

Clear discharge mixed with blood (sanitary discharge) indicates bullous or influenza-like otitis media . Bullae (vesicles with fluid) occur on the surface of the ear canal and eardrum. When they burst, the liquid with the ichor flows out through the ear canal into the auricle.

Which doctor to contact for ear discharge

In most cases, ear diseases are characterized by a clear clinical picture, which is based on pain. These patients are treated by an otorhinolaryngologist.

In the presence of a traumatic brain injury, which is accompanied by liquorrhea, urgent hospitalization is necessary. Otherwise, a poor prognosis is possible.

Discharge from the ear is not always accompanied by pain, in particular with allergic otitis, which is treated by

therapist

,

pediatrician

and

allergist-immunologist

.

Diagnosis and examination of discharge from the ear

If wax plug is suspected, the doctor performs an otoscopy, during which an accumulation of wax in the ear canal is detected. Diagnosis of otitis externa and otitis media is carried out on the basis of patient complaints, otoscopy, palpation of the parotid region. It is recommended to sow discharge from the ear to determine the causative agent of the disease and its sensitivity to antibiotics. Perhaps an audiometric study.

Ear culture, Routine. Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing

Synonyms: Ear Culture, Routine. Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing. Brief description of the study "Sowing of discharge from the ear on the microflora, determination of sensi...

Up to 6 business days

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RUB 1,805

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Traumatic brain injury, which is accompanied by liquorrhea, is diagnosed using radiography and CT.

X-ray of the skull

X-ray examination of the skull to detect structural and integrity disorders of the skull bones of various nature.

RUB 2,090 Sign up

CT scan of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

RUB 4,590 Sign up

To diagnose cholesteatoma and mastoiditis, the doctor performs otoscopy and radiography.

X-ray of the mastoid processes

X-ray examination of the mastoid process of the temporal bone to assess its integrity and identify other pathology.

RUB 2,090 Sign up

If otomycosis is suspected, endomicroscopic (examination of the ear under an operating microscope) and microbiological examination of ear discharge using microscopy and culture are recommended. Diagnosis of bullous otitis media includes sowing fluid from the ear, audio and tympanometry, and radiation examination methods. It is also possible to use serological methods of blood analysis.

Ear culture, Routine. Bacteria Identification. Antibiotic Susceptibility, enlarged testing

Synonyms: Ear Culture, Routine. Bacteria Identification. Antibiotic Susceptibility, enlarged testing. Brief description of the study “Sowing of discharge from the ear on the microflora and determination of sensitive...

Up to 6 business days

Available with house call

2 775 RUB

Add to cart

What to do if there is discharge from the ear

If clear discharge from the ear appeared after an injury, urgent hospitalization is necessary.

If there is an increased excretion of sulfur, you should seek the help of an ENT doctor who will recommend proper care and personal hygiene methods acceptable at home.

It is strongly not recommended to clean the ear canal with the help of items not intended for this purpose.

Treatment for ear discharge

If a sulfur plug is detected, the doctor removes it, after softening it with special preparations. Remove plugs by lavage or aspiration and curettage.

Irrigation is possible only in the absence of contraindications, which the doctor will definitely inform about (perforation of the tympanic membrane, otitis externa).

Treatment for otitis media may include pain relief, physiotherapy, and etiotropic therapy, depending on the causative agent of the disease. The allergic nature of ear discharge requires the use of antihistamines. Cholesteatoma is treated only with surgery.

Sources:

  1. Clinical guidelines "Acute otitis media". Developed by: National Medical Association of Otorhinolaryngologists. – 2021.
  2. Morozova S.V. Ear wax: topical issues of norm and pathology in clinical practice. breast cancer. No. 3 (II), 2018, pp. 53–57.
  3. Clinical guidelines "Chronic otitis media". Developed by: National Medical Association of Otorhinolaryngologists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Discharge from the ear

To the guide

Discharge from the ear often indicates the development of an inflammatory process in the outer or middle ear.

Article rating

3.60 (Votes: 10)

Ear wax protects against the penetration of pathogens and foreign bodies into the ear canal. Therefore, its formation is physiologically determined and is considered the norm. Other discharge from the ear usually indicates pathology and may contain purulent masses and blood impurities.

Types of discharge

According to their type of discharge are divided into several types:

Purulent discharge

The leakage of pus from the ear canal occurs with inflammation of the outer and middle ear, and is also characteristic of external and acute otitis media with perforation of the eardrum, respectively. Other causes of purulent discharge can be otomycosis, in which fungal microflora parasitizes in the ear, and furunculosis.

This is the name of the inflammation of the sebaceous glands in the ear canal, accompanied by the formation of a limited cavity (one or more), filled with a purulent secret. The clinical picture may be supplemented by other signs: the development of hearing loss, congestion and pain in the ear on the side of the lesion, a sensation of tinnitus, which is often mixed with dizziness. The physical condition of the patient is aggravated by a runny nose, fever, an increase in local lymph nodes, and pain in the ear region.

Spotting

Discharge from the ear with blood impurities also occurs with the development of an inflammatory process in the middle and outer sections. But the most common cause of such phenomena is trauma to the eardrum or other internal structures, as a result of exposure to mechanical objects that have fallen into the ear canal, or pressure drop. In the latter case, the cause may be barotrauma, which is often found in novice scuba divers with improper diving to depth due to a sharp change in the difference between external and internal fluid pressure.

Transparent highlights

There are also clear discharges from the ear. A striking example is exudative otitis media, during the development of which fluid accumulates in the middle ear cavity. Rupture of the tympanic membrane leads to the manifestation of the contents. Inflammation for this form of otitis is uncharacteristic.

Cerebrospinal fluid, which is also clear, may leak from the ear. A similar picture can be observed with craniocerebral injuries that led to a fracture of the base of the skull.

Diagnostics

Elucidation of the etiology of this phenomenon is carried out on the basis of the patient's own complaints and instrumental examination data.

As part of the diagnosis, otoscopy is used, the main task of which is to exclude pathology in the ear. The doctor also performs the toilet of the ear, clearing the ear canal from the contents, using micro-instruments. For a more detailed examination, otomicroscopy is used.

If an inflammatory process is confirmed, discharge from the ear is subject to microbiological examination, which makes it possible to establish the type of pathogen and identify its sensitivity to antibiotics.


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