Ear discharge

Definition

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, any fluid leaking out of an ear is ear wax.

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

Bleeding from the ear may also be due to:

• Cancer
• Foreign object in the ear canal
• Injury

Common Causes

• Eczema and other skin irritations in the ear canal
• 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
• Swimmer's ear -- usually accompanied by itching, scaling, a red or moist ear canal and pain that increases when you move the ear lobe

Home Care

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

EAR INFECTIONS

Treat inflammation or infection as your health care provider recommends. Your doctor may suggest ear drops.

EAR WAX

Use a gentle, warm water flush with a syringe (available at the drug store) to remove packed-down ear wax. Do not attempt to remove impacted ear wax in very young children. If you can easily see and retrieve ear wax in older children, do so carefully. NEVER use sharp objects to attempt to remove wax.

INJURY

Seek medical help for:

• Head injury
• Injury from a foreign object
• Noises or pressure changes
• Suspected clotting or bleeding problem

Don't get alarmed over a ruptured eardrum. Eardrum rupture 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 a medicine-dropper full of rubbing alcohol or a mixture of half rubbing alcohol and half white vinegar into the ear. This mixture will dry out the ear and kill any bacteria or fungi.
• Wiggle the ear to move the solution all the way down.
• 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 do you have (for example, fever, ear pain, headache)?

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

The doctor may recommend anti-inflammatory or antibiotic medicines, which are placed in 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.