Ear discharge Health Article

Definition

An ear discharge is drainage of blood, ear wax, pus, or fluid from the ear.

Alternative Names

Drainage from the ear; Otorrhea; Ear bleeding; Bleeding from ear

Considerations

Most of the time, fluid leaking out of an ear is ear wax. (For more information of this topic, see the article on ear wax.)

However, discharge may also be caused by minor irritation or infection. A ruptured eardrum can cause a white, slightly bloody, or yellow discharge from the ear. Dry crusted material on the child's pillow is often a sign of a ruptured eardrum.

Bleeding from the ear may also be due to injury, cancer, or a foreign object in the ear canal.

Common Causes

• Swimmer's ear -- usually accompanied by itching, scaling, a red or moist ear canal and pain increased by moving the ear lobe
• Inflammation or infection:
  • Otitis externa
  • Otitis externa - chronic
  • Otitis externa - malignant
  • Otitis media
  • Otitis media - chronic
  • Mastoiditis
• Injury from a blow to the head, foreign object, very loud noises, or sudden pressure changes (such as in airplanes), resulting in a ruptured or perforated eardrum
• Eczema and other skin irritations in the ear canal can cause some bleeding

Home Care

To be safe, never put anything in the ear smaller than the tip of your little finger.

EAR INFECTIONS

Treat inflammation or infection as advised by your health care provider. Your doctor may recommended ear drops.

EAR WAX

A gentle, warm water flush using a syringe (available at the drug store) can be used to remove packed-down ear wax. Do not attempt to remove impacted ear wax in very young children. If ear wax can be easily seen and retrieved in older children, do so carefully. NEVER use sharp objects to attempt to remove wax.

INJURY

Seek medical help for injury from a foreign object, noises or pressure changes, head injury, or a suspected clotting or bleeding problem.

Don't get alarmed over a ruptured eardrum. Eardrum rupturing is the first sign of the healing process. Antibiotics can help prevent further infection during the healing process. Eardrum ruptures in children will usually heal completely within a few weeks.

SWIMMER'S EAR

For swimmer's ear (unless the eardrum is perforated):

• Tilt the head sideways, with the water-filled ear up.
• Pull the ear upward and backward.
• Carefully squeeze into the ear a medicine-dropper full of rubbing alcohol, or a mix of half rubbing alcohol and half white vinegar. This mixture will dry out the ear, and kill any bacteria or fungus.
• Wiggle the ear to move the solution all the way down.
• Then, tilt the head again so that the affected ear is now down, and let the fluids drain out.

Putting a little mineral oil or baby oil in each ear before swimming may help prevent the problem.

Call your health care provider if

• The discharge is white, yellow, clear, or bloody.
• The discharge is the result of an injury.
• The discharge has lasted more than 5 days.
• There is severe pain.
• The discharge is associated with other symptoms, such as fever or headache.
• There is loss of hearing.

What to expect at your health care provider's office

The health care provider will perform a physical examination and look inside the ears. You may be asked questions, such as:

• When did the ear drainage begin?
• What does it look like?
• How long has it lasted?
• Does it drain all the time or off-and-on?
• What other symptoms are present? (For example, fever, ear pain, headache)

The doctor may get a sample of the ear drainage and sent it to a lab for examination.

The doctor may recommend anti-inflammatory or antibiotic medicines, which are placed into the ear. Antibiotics will be given by mouth if a ruptured eardrum is causing the discharge.

References

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005:2867-2871.

Behrman RE. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: WB Saunders: 2004; 2127.