OVERVIEW
The discharge from the ear can be blood, pus, watery fluid, or thick viscous fluid. Trauma to ear causes blood stained discharge while eardrum rupture can cause clear fluid, pus, or viscous fluid draining from ear.
Mostly the discharge from the ear due to infection is common in children but adults are equally prone to getting infections and subsequent fluid draining from the ear.
Causes of Fluid Draining From Ear
External Ear Infections:
- following external ear infections can cause discharge from ear.
- Diffuse otitis externa: it is inflammation of external ear skin and can spread to involve the tympanic membrane. It is also called ‘swimmer’s ear’ and occurs most commonly in swimmers and the people living in hot and humid environments and the ones who fail to dry their ears after bathing.
- Otomycosis: It is the fungal infection of the ear and causes intense itching of the ear and cause fluid draining from ear. The discharge is usually white, brown, or black in color and can cause ear pain and discomfort.
- Otitis externa hemorrhagic: it is characterized by the formation of granules of the eardrum and is seen in influenza epidemics. When granules rupture they cause intense itching and discharge from the ear.
- Necrotizing otitis externa: it is an inflammatory condition caused in elderly diabetics or in immunosuppressive individuals. There are excruciating pain and ear discharge.
- Eczematous otitis externa: it is due to hypersensitivity to topical ear drops and is characterized by irritation and vesicle formation on the ear.
Middle Ear Infections:
- Acute suppurative otitis media: infection of middle ear cleft i.e. Eustachian tube, mastoid air cells, ear bones. It is common in the low social class group and occurs after viral infections
- Serous otitis media: it is formed due to serous fluid draining from the ear. It is more seen in children and school going kids.
- Malignant otitis media: it is due to viral infections and causes rapid destruction of the whole of the eardrum and even mastoid cells. Healing is followed by adhesions.
- IMPACTED WAX: wax is composed of secretion of sebaceous glands, hair cells, keratin debris, and dirt. It has a protective function and helps to keep dirt and bacteria away. Sometimes wax causes fluid draining from ear which is a relatively benign condition.
- MISCELLANEOUS: Foreign body, maggots, traumatic rupture of the eardrum, and malignancy can also predispose to fluid draining from the ear.
Symptoms Associated With Ear Discharge
Fluid draining from ear can present as benign condition in which there is only fluid draining from ear with no other symptom while sometimes it can also present as
- Ear pain which might be slight to severe
- Ringing in your ears
- Bulging of eardrum
- Sore throat and sinusitis
- Fever
- Bloodstained discharge
- Nausea and vomiting which is usually a sign of inner ear infections.
How to Diagnose Fluid Draining From Ear?
Your doctor will ask you general questions about your health which will lead to help to fund out the causes of discharge. After taking your history he will examine your ear by
- Otoscope, an instrument to see inside of ear especially eardrum.
- Culture and sensitivity of ear discharge
- Gram staining of ear discharge
- Audiometry to access the hearing status
- Hearing assessment tests
Treatment of Fluid Discharge
From External Ear
- Antibiotics (oral or topical)
- Analgesics or painkillers
- Local heat to relieve pain and inflammation
- Incision and drainage of abscess if it is formed followed antibiotics uptake.
- Medicated wicks, after toilet of the ear, wick soaked in antibiotic and steroid preparation is inserted in the ear canal and the patient is advised to keep it moist by instilling the same drops twice or thrice a week
- Local steroids
- Sulpur and Salicylic acid for seborrheic otitis externa
From Middle Ear
Middle ear infections are the most common cause of ear discharge and usually occur after inflammation of nasal mucosa.
- Ear toilet, which is mopping of fluid draining from ear by cotton buds
- Topical nasal decongestants which are applied directly into the ear
- Oral nasal decongestants which are given orally and they help relieve sinusitis and pharyngitis
- Analgesics and antipyretics e.g paracetamol
- Middle ear aeration in which the patient is taught to continuously perform Valsalva maneuver
- Eardrum Incision and aspiration of fluid
- Surgical treatment of causative factor e.g tumor and maggots
How to Prevent Fluid Discharge from Ear?
- Keep ear hygiene and keep it dry after bathing
- Control recurrent sore throat and nasal allergies
- Treat pharyngitis timely
- Control of diabetes
- Prevent the use of steroids
- Prevent topical nasal and ear drops
- Attention must be paid to nasal vestibules which may harbor numerous bacteria
- Prevent ear trauma and accidents
- Keeping vaccination of children up to date
- Preventing smoking
Home Remedies to Cure Ear Discharge
- Use earplugs while bathing to prevent water from entering the ear
- Using head caps while showering
- Avoidance of ear scratching even with the soft cotton ball as it can exacerbate infections
- Avoiding cleaning ear wax yourself
- Cleaning up of ears
Complications and Outlook
Untreated fluid from the ear can predispose to the formation of furuncle, carbuncle, or even abscess which requires surgical drainage in most of the cases. Every attempt should be made to prevent such happenings. Treatment of causative factors should eliminate the risk of fluid discharge from ear.
If an ear infection is left untreated it can cause chronic disease and can even affect auditory functions i.e. hearing functions of the ear. Fluid discharge from ear is usually a mild condition that heals on its own if it is not associated with complications. Any delay in treatment can lead to severe infection and increase the risk of long term risks most hazardous of which is hearing loss.
When to Call Your Healthcare Provider?
Call your doctor if the discharge is a result of injury, lasted more than 3 days, it is yellow, white, pus-filled or blood-stained, has severe pain in-ear, or associated symptoms like fever, headache, nausea, vomiting or tinnitus. Call your general practitioner immediately if you feel any facial weakness or asymmetry as it can be due to the involvement of the facial nerve.
HP Thoughts: Learn about ear discharges and their types here — Types of Ear Discharge.
