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Fluid Draining From Ear: Overview, Causes, Symptoms and Treatment

A doctor looking into an ear with an otoscope
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Photo by Grook Da Oger, CC BY-SA 3.0, via Wikimedia Commons

OVERVIEW

Discharge from the ear (the medical term is otorrhea) can be clear, watery, pus-like, thick, or blood-stained. According to Cleveland Clinic, it most often comes from a ruptured eardrum caused by a middle ear infection.

Injury to the ear can cause blood-stained discharge. A torn eardrum can let out clear fluid, pus, or thick fluid.

Important: Clear or bloody fluid from the ear after a head injury can be a sign of a skull fracture or a leak of the fluid around the brain. Call 911 or go to the emergency room right away.

Fluid Draining From Ear

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Ear infections that cause discharge are most common in children, but adults can get them too.

Causes of Fluid Draining From Ear

External Ear Infections:

  • The following outer ear problems can cause discharge from the ear.
  • Diffuse otitis externa: inflammation or infection of the skin of the ear canal, also called "swimmer's ear." It is common in swimmers, in hot and humid climates, and in people who scratch their ear canal or clean it with cotton swabs. Drainage may be yellow, yellow-green, pus-like or foul-smelling.
  • Otomycosis: a fungal infection of the ear canal. It causes intense itching, discomfort and discharge that may be white, gray, brown or black.
  • Otitis externa hemorrhagica (bullous myringitis): painful, blood-filled blisters form on the eardrum and nearby canal, often after a cold or flu. When the blisters burst, they can cause bloody discharge.
  • Necrotizing (malignant) otitis externa: a serious infection that spreads to the skull bone, mostly in older people with diabetes or a weak immune system. It causes severe pain and discharge and needs urgent treatment, often with IV antibiotics.
  • Eczematous otitis externa: an itchy, irritated ear canal caused by skin conditions such as eczema or by an allergy to ear drops.

Middle Ear Infections:

  • Acute suppurative otitis media: a bacterial infection of the middle ear, often after a cold. Pressure from pus can tear the eardrum and cause sudden discharge, often with relief of pain.
  • Otitis media with effusion (serous otitis media): fluid trapped behind an intact eardrum without active infection. It is common in children. It usually causes muffled hearing rather than drainage, unless there is a hole in the eardrum or an ear tube.
  • Chronic otitis media and cholesteatoma: a long-lasting hole in the eardrum or a skin cyst in the middle ear can cause repeated, often smelly, discharge. These need care from an ear specialist.
  • IMPACTED WAX: Earwax is made by glands in the ear canal and helps keep dirt and bacteria away. Wax mixed with water after a shower or swim can look like a runny discharge, which is usually harmless.
  • MISCELLANEOUS: A foreign object, an injury that tears the eardrum, a skull fracture, or, rarely, a tumor can also cause fluid draining from the ear.

Symptoms Associated With Ear Discharge

Fluid draining from ear can occur on its own with no other symptom, or it may come with:

  • Ear pain, which might be slight to severe
  • Itching
  • Ringing in your ears
  • Hearing loss
  • Fever
  • Bloodstained discharge
  • Dizziness, nausea or vomiting, which can mean the inner ear is involved

How to Diagnose Fluid Draining From Ear?

Your doctor will ask about your symptoms and health history to help find the cause of the discharge. Then they may check your ear using:

  • An otoscope, an instrument to see inside the ear, especially the eardrum.
  • A culture of the ear discharge to find the germ causing the infection
  • Hearing tests, such as audiometry
  • CT or MRI scans in some cases, for example after a head injury

Treatment of Fluid Discharge

Treatment depends on the cause. Don't put anything in your ear, including drops, until a doctor has checked whether the eardrum is torn.

From External Ear

  • Antibiotic ear drops, usually for 10 to 14 days for swimmer's ear, according to MedlinePlus
  • Antifungal drops for fungal infections
  • Pain relievers such as acetaminophen or ibuprofen
  • A warm compress against the ear to ease pain
  • Cleaning of the ear canal by a doctor, using suction or special tools
  • An ear wick: if the canal is very swollen, a doctor may place a small sponge wick so the drops can reach deep into the canal; use the drops exactly as prescribed
  • Steroid drops to reduce itching and swelling
  • Antibiotics by mouth if the infection spreads beyond the ear canal

From Middle Ear

Middle ear infections are the most common cause of ear discharge and often follow a cold or other nose and throat infection.

  • Many mild middle ear infections get better on their own. The CDC says severe infections, or those lasting more than 2 to 3 days, need antibiotics.
  • Antibiotic ear drops if the eardrum has a hole or there is an ear tube
  • Gentle cleaning of discharge from the outer ear with a clean cloth; don't push cotton swabs into the ear canal
  • Pain and fever relief such as acetaminophen (paracetamol) or ibuprofen; never give aspirin to children
  • A torn eardrum usually heals on its own within a few weeks; some need surgery to repair it
  • Ear tubes for children with repeated infections or long-lasting fluid
  • Surgery for chronic infection, cholesteatoma or a tumor

How to Prevent Fluid Discharge from Ear?

  • Keep your ears dry after bathing or swimming
  • Don't scratch your ear canal or clean it with cotton swabs or other objects
  • Treat nose and throat infections and allergies
  • Control diabetes
  • Use ear drops only as directed by your doctor
  • Protect your ears from injury
  • Keep children's vaccines up to date, including flu and pneumococcal vaccines
  • Avoid smoking and keep children away from cigarette smoke

Home Remedies to Cure Ear Discharge

Home care can't cure an infection, but these habits help prevent problems and support healing:

  • Use earplugs while swimming to keep water out of the ear
  • Use a shower cap while showering
  • Avoid scratching inside the ear, even with a soft cotton bud, as it can worsen infections
  • Avoid trying to dig out ear wax yourself
  • Gently wipe away discharge from the outer ear only

Complications and Outlook

Most ear discharge from a simple infection clears up with the right treatment. Untreated infections can spread to nearby skin or bone or form an abscess that needs drainage.

If an ear infection is left untreated, it can become chronic and affect your hearing. Prompt treatment lowers the risk of long-term problems, the most serious of which is hearing loss.

When to Call Your Healthcare Provider?

Call your doctor if the discharge lasts more than 3 days, is yellow, white, pus-filled or blood-stained, or comes with severe ear pain, fever, headache, hearing loss, dizziness or ringing in the ear.

Get emergency care right away if the discharge follows a head injury, or if you notice facial weakness, trouble swallowing, speaking or seeing, or a stiff neck. People with diabetes or a weak immune system should get any ear drainage checked promptly.

HP Thoughts: Learn about ear discharges and their types here: Types of Ear Discharge.

Sources

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