Feature Article

The discharging ear. A good history tells the story




A significant number of discharging ear conditions can be diagnosed through taking a history, with the type of discharge (purulent, clear or blood-stained) often signalling the aetiology. 

Key Points

  • The discharging ear can represent a large variety of conditions that can occur in patients of any age.
  • Taking a history is an essential part of the assessment of patients with ear pathology.
  • Common causes of purulent or mucoid discharge include otitis externa, a foreign body, a cholesteatoma or otitis media with perforation of the tympanic membrane.
  • Clear discharge is an uncommon form of otorrhoea in general practice. Usually the history indicates underlying aetiology.
  • Blood-stained discharge usually causes significant concern to the patient. It has a range of possible causes from more benign pathology such as acute otitis media to more serious concerns such as middle ear or ear canal tumours.
  • Classifying the type of discharge present allows the various common aetiologies to be considered, enabling accurate treatment or referral of the patient.

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