Ear Discharge

CLINICAL DIAGNOSIS MANUAL

Ear discharge, or otorrhoea, is the drainage of fluid from the ear, which can range from serous to purulent depending on the underlying cause. This condition may be symptomatic of various diseases of the middle and external ear, as well as more serious complications.

Pathology	Diagnosis of Suspicion	Diagnosis of Confirmation
Acute Otitis Media	Acute ear pain, fever, hearing loss, possible otorrhoea if tympanic rupture occurs.	Otoscopic examination showing middle ear inflammation, effusion, or tympanic membrane perforation.
Otitis Media with Effusion	Feeling of fullness in the ear, hearing loss, recent history of infection without active inflammation.	Otoscopy showing effusion without signs of acute infection, confirmed by tympanometry.
Chronic Suppurative Otitis Media	Chronic discharge, persistent tympanic perforation, recurrent episodes of pain and fever.	Confirmatory otoscopic examination showing perforation and discharge, possible secretion culture.
Cholesteatoma	Ear discharge with a history of recurrent infections, possible progressive hearing loss.	Diagnosis by CT scan to assess the extent of abnormal growth and involvement of adjacent structures.
Chronic Otitis Externa	Itching, chronic discharge, pain when touching the tragus, history of moisture exposure.	Otoscopic examination showing an inflamed and possibly stenosed ear canal, secretion culture.
Ear Canal Trauma	History of trauma or insertion of an object into the ear, pain, possible bleeding and discharge.	Clinical and otoscopic examination showing canal injuries or tympanic membrane perforation.
Cerebrospinal Fluid Otorrhoea	History of recent cranial trauma or skull base surgery, clear and watery ear discharge.	Beta-2 transferrin or glucose test of the otorrhoeic fluid to confirm the presence of cerebrospinal fluid.