Ear Discharge

EAR DISCHARGE OR DRAINAGE

Symptom Definition

  • Drainage of substances with varied colors and consistency from the ear canal.
  • Drainage through an ear tube is included.

Causes

  • Normal discharge: earwax or water. Earwax is light brown, dark brown, or orange brown in color
  • Main cause of abnormal discharge: an ear infection with drainage of cloudy fluid or pus through a ruptured eardrum or through a ventilation tube.

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WHEN TO CALL YOUR DOCTOR

Call your doctor now (night or day) if:

  • Your child looks or acts very sick.
  • Pink or red swelling behind the ear.
  • Clear or bloody fluid following head injury.
  • Bleeding from the ear canal (Exception: few drops and follows ear exam).
  • Fever above 104 F (40 C) and not improved 2 hours after fever medicine.

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think your child needs to be seen.
  • Ear pain or unexplained crying.
  • Discharge is yellow or green, cloudy white or foul-smelling (pus).
  • Clear drainage (not from a head injury) persists for more than 24 hours.

Call your doctor during weekday office hours if:

  • You have other questions or concerns

Parent care at home if:

  • Probably normal earwax or other harmless discharge and you don't think your child needs to be seen.
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HOME CARE ADVICE FOR EAR DISCHARGE

  1. Earwax:
    • Ear wax protects the lining of the ear canal and has germ-killing properties.
    • If the earwax is removed, the ear canals become itchy.
    • Do not use cotton swabs (Q-tips) in your child's ear.
    • Call Your Doctor If: Begins to look like pus (yellow or green discharge)
  2. Clear Discharge (without head trauma):
    • It's probably tears or water that entered the ear canal during a bath, shower, swimming or water fight.
    • Don't overlook eardrops your child or someone else used without telling you.
    • In children with ventilation tubes, some clear or slightly cloudy fluid can occur when a temporary tube blockage opens up and drains.
    • Call Your Doctor If: Clear drainage persists for more than 24 hours or recurs
  3. Blood After Ear Exam:
    • If your doctor had to remove ear wax in order to see the eardrum, about 10% of the time this causes a small scratch to the lining of the ear canal. Usually the scratch oozes 1 or 2 drops of blood and then clots.
    • This should heal up completely in a few days.
    • It shouldn't affect the hearing.
    • Don't put anything in the ear canal because it will probably re-start the bleeding.
    • Call Your Doctor If: Bleeding continues or recurs
  4. Suspected Ear Infection: Cloudy fluid or pus draining from the ear canal almost always means there's a small tear in the eardrum and a middle ear infection. Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief until the office visit. (See EARACHE for details)
  5. Call Your Doctor If:
    • Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. Ah-Tye C, Paradise JL, Colborn DK. Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration. Pediatrics. 2001;107:1251-1258.
  2. Bitar CN, Kluka EA, Steele RW. Mastoiditis in children. Clin Pediatr. 1996;35:391-395.
  3. Guest JF, Greener MJ, Robinson AC, Smith AF. Impacted cerumen: composition, production, epidemiology and management. Q J Med. 2004; 97:477-488.
  4. Schwartz RH and Bahadori RS. What to do for runny ears. Contemp Pediatr. 1999;16(5):121-131.
  5. Urkin J, Gazala E, Bar-David Y. Cleaning earwax: why you shouldn’t play it by ear. Contemporary Pediatrics. 2004; 21(2):73-86.
  6. Whatley VN, Dodds CL, Paul RI. Randomized clinical trial of docusate, triethanolamine polypeptide, and irrigation in cerumen removal in children. Arch Pediatr Adolesc Med. 2003; 157:1177-1180.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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