Ear discharge : When should you visit the ER

Ear discharge is often a private problem. Few want to discuss it. It’s also easy to ignore since you don’t see the condition inside your ear. It’s an easily treatable and preventable condition.

In this post, I will tell you

  • All your options with ear discharge.
  • When you should definitely visit the ER.
  • What are your options to get treated 

Estimated reading time: 5 minutes

What are the causes of ear discharge?

Ear discharge occurs  when  secretions occur due to  infections in various parts of the ear.

*Otitis externa : Infection involving external ear.

Furuncle/boil 

Otomycosis:fungal infection

Acute otitis media
Pus gets trapped behind the eardrum and the pressure may cause the drum to rupture and pus mixed with blood gets released. This generally occurs after an untreated cold for a period of 5 to 7 days. Accompanied by fever and earache. Rupture of the eardrum occurs with a decrease in pain and pus with bloody discharge.

Chronic otitis media

When ear infection causes persistent discharge for more than 12 weeks. This often presents with ear drum perforation, ear discharge, and reduced hearing.

*Otitis media with effusion

Generally allergic rhinitis, adenoid tissues, and Tonsillitis may cause this. In this case, a sticky discharge occurs.

*CSF Otorrhea

Following head injury, if the junction between your ear and brain is breached the brain fluid may leak.

Potentially serious condition with a risk of meningitis.

Types of ear discharge:

Watery: CSF Fluid covering the brain. You may think water is coming out of your ear.
*Mucoid: Middle ear goblet cells are the source . Indicates ear drum perforation. This is sticky like the goo which comes out of your nose when you have a cold. It’s a white discharge from the ear.
*Pus: Otitis externa/furuncle/infected fungal infection, squamous type of Chronic otitis media.
Pus+mucus: Infected mucus, indicates ear drum perforation.Chronic otitis media mucosal type when there occurs ear drum perforation.

Blood coming out of the ear has to be managed by an ear doctor.
*Pus+blood: squamous type of Chronic otitis media potentially serious and needs urgent management.

*Pus+mucus+blood.:Chronic otitis media mucosal type with granulation
potentially serious and needs urgent management.

What are the important investigations you should do?

*Otoendoscopy: A  chance for you to Visualize the inside of your own ear and see the problem.

*Pure tone audiometry: PTA. Helps to assess diminished hearing which can occur due to ear discharge.

*Tympanometry: Eardrum problems like a thinned drum, and the perforated drum is diagnosed  You can also detect fluid behind an intact drum.

*HRCT temporal bone: This is computed tomography of your ear bone and helps detect, how far the disease has progressed.

What are the options for treatment for discharging the ear

Treatment  may be:
*Surgical:Chronic Otitis media squamous type( having cholesteatoma and granulations)
*Medical: Acute otitis media, Otomycosis, furuncle of the ear.
*Surgical+Medical: Chronic otitis media

What are the other complaints associated with ear discharge? 

*Swelling  behind the ear: post-aural abscess
*Partial or complete loss of hearing

Ear ache: more common in acute otitis media, ear furuncle, and fungal ear infection.Less common in chronic otitis media. If earache occurs in Chronic otitis media it’s considered a dangerous sign.

READ more about

Earache

*Dizziness

*Ringing sound in the ear: Tinnitus

*Acute and chronic mastoiditis Infection and inflammation of the Mastoid bone.
*Post aural fistula: Opening in the skin behind the ear connecting with the Mastoid bone.(This occurs in Chronic otitis media eroding the bone .)

*Accompanying signs such as fever and headache often indicate the potential involvement of the brain.
Meningitis, Brain abscess, and other intracranial complications.

*Facial palsy: Disease can cause involvement of the facial nerve.Deviation of mouth, difficulty closing eye, the problem with chewing, eating, blowing, and puffing.

Treatment  depends on the exact cause 

Often ear discharge is a symptom ignored for a long. Avoidance of the problem will put you at risk of serious complications including, permanent hearing loss. Like a friend of mine, who after ignoring repeated bouts of airplane ear developed chronic otitis media and persistent ear discharge.

When should you visit the ER, with ear discharge?

  • Ear pain not decreasing
  • Profuse bleeding from the ear
  • Slap injury /sharp injury to the ear
  • High-grade fever with ear discharge and headache
  • Ear discharge with dizziness nausea and vomiting
  • Sudden hearing loss with ear discharge
  • Facial deviation with ear discharge
  • Swelling behind the ear with ear discharge

These are all danger signs and need immediate intervention.

Is ear discharge not stopping?This is what you must know.

Where can you get help?

In India, all Government Medical colleges have a good ENT setup.Plus it’s free

In Delhi:

AIIMS

Safdarjung Hospital

Maulana Azad Medical College

GTB Hospital and Medical College

Kolkata

Calcutta Medical College

NRS Medical College

SSKM Medical College

CNMC

R.G.Kar Medical college

Ear discharge in children needs early treatment to prevent long-term sequelae and irreversible damage.

Private medical colleges with excellent Ear surgery in Kolkata

What other queries do you have about ear discharge? Let me know in the comments below.

Shishumangal Hospital and Vivekananda Medical college

Disclaimer: This health info is meant for educational purposes only and should not be confused as professional medical advice.


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By Dr.Amrita Basu(MBBS,MS)

I am an ENT surgeon by profession, previously working at a Medical college. I believe the Internet is God's way of providing health and wealth information for all. The important thing is to find the right information.

12 comments

  1. Hey Doc, it’s very informative article on ear discharge and I am sure it’s something must read to be wise, call on their medical expert. I didn’t know bout the symptoms and you wrote it in a very friendly language, easy to understand.

  2. This is really interesting. My son had an ear infection in the summer and it was horrible to see the effects on him.

    1. Unfortunately children can have a very bad time with ear infection. It’s important to take special care.
      No forceful ear cleaning, avoid water entry in ear

  3. Very informative and given in full detail. Ear discharge most often is not taken seriously until there is pain, especially in children it becomes even more difficult to differentiate.

    1. Hi Mahek ,
      excessive ear bud use can cause minor skin lacerations. This can get infected in a small location and cause a boil.Or diffusely then called otitis externa.Very painful condition.Needs antibiotics, pain killers ,ear drop and hot fomentation

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