Pus Leaking From The Ear Symptoms, Causes & Common Questions
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Pus leaking from the ear symptoms
The ear is a body part not only responsible for hearing but also activities such as balance and proprioception (the medical term used to describe your body’s ability to sense its orientation in relation to the environment).
The ear is part of the body’s vestibular system and is composed of three main parts and connecting structures:
- Outer/external ear (pinna): This consists of the outside portion visible to the eye and a canal that runs from the eardrum to the outside of the head.
- Middle ear: This consists of three small bones that connect and transmit sound waves from the outside world to the inner ear.
- Inner ear: This consists of nerves and receptors necessary for hearing and balance.
- Other structures: The ear is also composed of a tympanic membrane (eardrum) that divides the outer ear from the middle ear, and a Eustachian tube. The Eustachian tube is a structure that links the middle ear to the nose and helps equalize pressure in the middle ear.
See this image for a visual representation of the outer, middle and inner parts of the ear and its different components.
The hollowness of the ear makes it susceptible to foreign materials and infection. Pus leaking from the ear is a telltale sign on infection. If you are experiencing pus leaking from the ear, make an appointment with your doctor promptly.
Common characteristics of pus leaking from the ear
Pus leaking from the ear can be the result of many disease processes and can have many different appearances. It is ultimately the result of the body’s immune system reacting to infection. Neutrophils, a type of white blood cell in charge of attacking harmful pathogens, accumulate in affected areas and lead to the presence of pus.
The drainage from your ear may have the following characteristics:
- Thick, white-yellow, yellow, yellow-brown: This is due to the accumulation of dead neutrophils.
- Green: This is due to the presence of an antibacterial protein produced by some types of white blood cells called myeloperoxidase.
- Green and foul-smelling: This is due to bacteria that produce a greenish pigment called pyocyanin .
Common accompanying symptoms
Since pus leaking from the ear can be associated with many different conditions, symptoms can vary. Most often, patients are largely asymptomatic in the beginning; however, other symptoms associated with pus in the ear can develop as the condition progresses and can include:
- Congestion or runny nose
- Pain that radiates from the ear to the face or sinuses
- Hearing loss
If you notice any of these symptoms, make an appointment with your doctor promptly in order to follow up on your symptoms, get a diagnosis and receive appropriate care.
Pus leaking from the ear causes
As discussed above, pus is the result of the body responding to infection. Infection of the ear resulting in drainage of pus can occur in many different ways. Infection of the inner ear components is known as otitis media and infection of the outer ear is known as otitis externa.
More about infection
Infections of the ear that result in pus are largely bacterial or fungal:
- Bacterial: Because the ear is open to the outside environment, it is very susceptible to bacterial causes of infection. These organisms are often present on the skin and easily infect the tissues of the ear. This causes entrance of fluids into the tissues that result in inflammation, swelling and other symptoms.
- Fungal: Otomycosis is a fungal infection of the external ear, middle ear and open mastoid cavity. Fungi such as candida and aspergillus have a predilection for the ear and also often infect people with weakened immune systems.
Conditions that result in excess moisture inside the ear canal create an environment ideal for bacterial and fungal growth.
- Environmental: External factors such as swimming and heavy perspiration put moisture directly into the ear canal. Repeated exposure can result in bacterial growth and future infection that leads to fluid accumulation within the ear. Earwax is a natural component of the ear that works to protect, clean and lubricate the ear; however, it can also accumulate and cause similar symptoms.
- Structural: Some people have narrow ear canals that make drainage of moisture more difficult. This structural anomaly causes a blockage that traps water and promotes bacterial growth and infection that results in swelling.
- Devices: Items that you put directly into your ear such as headphones or hearing aids can also cause a blockage that traps excess water and results in otitis externa.
- Tumors: Benign and malignant tumors can block the ear and lead to wax build-up, which can cause recurrent attacks of otitis externa
Trauma to the ear can result in cuts and lesions that predispose growth of bacterial and fungal pathogens. Trauma to the ear can occur in a variety of ways including:
- Ear cleaning habits: Using ear swabs to clean the ear of earwax or debris may contribute to pathogenesis due to direct injury to the skin barrier of the ear. Furthermore, ear swabs can perforate the eardrum if placed too far into the canal and cause many negative symptoms including infection.
- Iatrogenic (medical related): Procedures or operations to the ear can predispose an individual to the development of infection by altering the anatomy and local environment of the ear canal and producing changes in earwax production or humidity, favoring fungal growth.
Individuals with weakened immune systems due to genetic, acquired or systemic conditions are very susceptible to infection by a wide array of pathogens. In such individuals, the ears are not spared, and pus leakage due to infection is a very common occurrence.
This list does not constitute medical advice and may not accurately represent what you have.
Swimmer's ear (otitis externa)
Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.
It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.
Most susceptible are children, because they have narrower ear canals that do not drain well.
Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.
Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.
Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.
Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.
Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving
Urgency: Primary care doctor
Chronic ear infection (suppurative otitis media)
Chronic Suppurative Otitis Media is persistent drainage from the middle ear due to a damaged membrane. It is considered chronic when it lasts for more than 6 weeks.
Top Symptoms: ear canal pain, pus leaking from the ear, hearing loss in one ear
Symptoms that always occur with chronic ear infection (suppurative otitis media):pus leaking from the ear
Urgency: Primary care doctor
Ear wax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum, which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside. Ear wax buildup has nothing to do with poor hygiene, and it is not possible to prevent a build-up by washing.
Top Symptoms: dizziness, dry cough, ear canal pain, ear fullness/pressure, ringing in the ears
Symptoms that never occur with earwax blockage: swollen ear, fever
Urgency: Phone call or in-person visit
Pus leaking from the ear treatments and relief
At the onset of symptoms, it is important to seek prompt medical attention and get your doctor’s advice before trying things for yourself at home. Moreover, at-home treatment for most causes of pus leaking from the ear self-resolve and involve supportive measures such as rest and hydration.
When to see a doctor
Your healthcare professional will treat the pus accumulation by stopping the infection and allowing the ear to heal.
- Drainage/Cleaning: Your doctor will use suction or a small device to drain water and clear away debris, earwax or extra skin. This is necessary to allow for the next step, the antibiotic eardrops, to move freely through all infected areas of the ear. Depending on the extent of blockage or swelling, your doctor may insert cotton or gauze in the ear to promote drainage instead.
- Eardrops: Your doctor will prescribe eardrops with a combination of ingredients that fight bacteria and fungi as well as reduce inflammation and help restore your ear’s normal pH balance.
In order to prevent ear infection, there are many things you can do at home and change in your normal routine.
- Keep your ears dry: Thoroughly dry your ears after exposure to moisture from swimming or bathing. Practice techniques such as tipping the head to the side to help water drain from the ear canal, and wipe the outer ear slowly and gently with a towel.
- Do not put foreign objects in your ear: Do not attempt to scratch or dig out earwax with objects such as cotton swabs or paper clips. These items may not only irritate or break the skin in your ear but can also pack the material deeper into your ear canal, worsening blockage and moisture buildup.
- Protect your ears from irritants: Be conscious of the type and quality of jewelry and piercings you use on your ears. Furthermore, protect your ear canal from hair sprays and dyes by using cotton balls or other protective measures.
When it is an emergency
If you notice that your ear infection has spread, either to other parts of the skin or base of the skull, seek medical attention immediately. This is a condition known as necrotizing otitis externa and requires urgent systemic antibiotics to control the spread of the infection.
FAQs about pus leaking from the ear
Will I regain my hearing after my ear infection?
Hearing loss in the setting of an ear infection can be a scary and concerning symptom. Fortunately, the hearing loss is not the result of damage or injury to the ear but rather a temporary obstruction of the middle ear that prevents sound waves from reaching the inner ear/brain. In most situations, once the fluid accumulation resolves, hearing is restored.
How can I tell if my child has an ear infection?
Ear infections occur most often in young children who usually do not have the capacity to properly communicate their symptoms. However, there are many signs you can look for that may indicate your child has an ear infection. These signs include your child is pulling or tugging at their ears, are increasingly irritable (having trouble sleeping, are crying more or are fussy), they have a fever, they have drainage coming from their ear, or they have problems with balance or clumsiness.
Is earwax bad?
Earwax is good is small amounts. It is the ear’s natural protectant and important for preventing bacterial and fungal infection. However, too much earwax can cause blockage and predispose the ear to infections and other problems. It is important to regularly clean the ears with either saline or hydrogen peroxide on cotton balls or via a bulb syringe.
Why shouldn’t I use cotton swabs?
You may think that cotton swabs can help clean out the ears; however, they usually end up pushing wax and debris deeper into the ear canal. Cotton swabs are also dangerous because they can irritate the skin and even perforate the eardrum if pushed too far.
Why is the pus leaking out of my ear green and foul-smelling?
If the pus from your ear looks green or foul-smelling, you may have an ear infection caused by a bacterium called Pseudomonas aeuroginosa. Pseudomonas produces a green pigment called pyocyanin and infections by this bacterium are particularly foul-smelling.
Questions your doctor may ask about pus leaking from the ear
- Any fever today or during the last week?
- Do you use cotton-tipped swabs (q-tips) to clean your ears?
- Have you ever been diagnosed with diabetes?
- Do you often come into contact with hot tubs, swimming pools, or other sources of standing water?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.
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