What Is Bullous Myringitis?

Medically reviewed by Daniel Murrell, MD on December 14, 2017Written by Erica Hersh on December 14, 2017

Overview

Bullous myringitis is a type of ear infection in which small, fluid-filled blisters form on the eardrum. These blisters usually cause severe pain.

The infection is caused by the same viruses or bacteria that lead to other ear infections. However, bullous myringitis doesn’t cause fluid to build up behind the eardrum, like with some other ear infections. With treatment, bullous myringitis can go away within a few days.

What are the symptoms?

Symptoms of bullous myringitis are similar to other types of ear infections. Symptoms may include:

  • Severe pain. The pain comes on suddenly and lasts 24 to 48 hours.
  • Hearing loss in the affected ear. Hearing loss will usually go away once the infection clears.
  • Fever.
  • Fluid draining from the ear. This will only happen if one of the blisters breaks. Unlike other types of middle ear infections, bullous myringitis doesn’t cause a buildup of fluid or pus in the ear, but other middle ear infections can occur at the same time.
  • Full feeling in the ears.
  • Irritability. If your young child has bullous myringitis, they might seem irritable from the pain.
  • Tugging or pulling at ear. A child too young to vocalize their ear pain might tug or pull at their ear in an attempt to relieve the pain.

What are the causes?

Bullous myringitis can be caused by bacteria or a virus. The bacteria and viruses that cause bullous myringitis are the same ones that cause other types of ear infections and conditions such as the flu, common cold, and strep throat. Streptococcus pneumoniae, which is a type of bacteria that causes strep throat, is a particularly common cause of bullous myringitis.

What are the risk factors?

Bullous myringitis is more common in people who already have an upper respiratory tract infection, such as the flu or cold. This is because these infections can irritate the eustachian tubes or otherwise stop them from draining fluid properly. Fluid that contains bacteria or viruses from the respiratory infection then moves into the ear and causes an infection.

Bullous myringitis is also more likely to occur in people with a middle ear infection. This is because they’re both caused by the same viruses and bacteria.

Just like with other types of ear infections, children are more likely than adults to get bullous myringitis, especially if they spend time in day care or go to school.

How is this diagnosed?

If your only symptom of bullous myringitis is pain, you can wait a day or two to see if the pain goes away before calling your doctor. If the pain is very severe, which is common in bullous myringitis, or if you have a fever, call your doctor immediately. Also call your doctor if you have trouble hearing or have fluid coming from your ears.

If your child is showing signs of ear pain, you should always call a doctor, especially if they have a history of ear infections.

Your doctor will take your medical history and ask about your symptoms and how long you’ve had them. They’ll also use a handheld device called an otoscope. This device has a magnifying glass and light to help your doctor see inside your ear and figure out if you have an ear infection.

If you do have an ear infection, your doctor will determine if it’s bullous myringitis or another type of infection. If you have bullous myringitis, they’ll be able to see the blisters on your eardrum. Your doctor might also do a hearing test to assess any hearing loss from the infection.

What are the treatment options?

Treatment for bullous myringitis usually includes over-the-counter pain relievers and antibiotics. Both of these can be taken either by mouth or in eardrops. It will depend on preference and age.

Although viruses can cause bullous myringitis, antibiotics are usually prescribed. This is because it can be hard to tell if a virus or bacteria have caused the infection. Symptoms usually improve within two days.

If pain relievers don’t help reduce your pain, your doctor might break open the blisters on your eardrum with a small knife to allow them to drain. This won’t cure the infection, but it will help relieve your pain while you take antibiotics.

Are there any complications?

Bullous myringitis can lead to hearing loss, but this symptom generally disappears after treatment.

In rare cases, if bullous myringitis isn’t treated effectively, the bacteria or virus that cause it can spread to the bones around the ear. If the spread of infection isn’t treated, it can lead to deafness, meningitis, or sepsis.

Are there ways to prevent this?

Bullous myringitis is caused by the same types of viruses and bacteria that cause respiratory infections, colds, and other ear infections. Bullous myringitis itself isn’t contagious, but the other infections that can lead to it are. The best way to prevent bullous myringitis is to take steps to avoid catching colds or other infections.

Some of the best ways to avoid these infections are:

  • Stay away from people with colds or other contagious infections as much as possible.
  • Wash your hands regularly.
  • Try not to touch your eyes, nose, and mouth.
  • Get a good night’s sleep.
  • Keep surfaces in your home clean, especially if someone in your household has recently had a cold.

What’s the outlook?

Bullous myringitis is a very painful type of ear infection, but symptoms usually go away within a few days after treatment. The infection itself isn’t contagious and rarely causes any long-term complications.

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