Ear Discharge (Otorrhea): Or something else? Differential Diagnosis

Skin and subcutaneous (L00-L99).

Infectious and parasitic diseases (A00-B99).

Musculoskeletal system and connective tissue (M00-M99).

  • Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis – necrotizing (tissue dying) vasculitis (vascular inflammation) of the small to medium-sized vessels (small-vessel vasculitides), which is associated with granuloma formation (nodule formation) in the upper respiratory tract (nose, sinuses, middle ear, oropharynx) as well as the lower respiratory tract (lungs)

Neoplasms – tumor diseases (C00-D48).

Ears – mastoid process (H60-H95).

  • Acute purulent otitis media (inflammation of the middle ear).
  • Acute mastoiditis (mastoid process inflammation).
  • Cerumen (earwax), liquefied.
  • Cholesteatoma – ingrowth of multilayer keratinizing squamous epithelium in the middle ear with subsequent chronic purulent inflammation (“chronic bone suppuration”).
  • Chronic otitis media (inflammation of the middle ear).
  • Chronic mesotypmpanal otitis media (CMOM; chronic mucosal suppuration with central defect in the pars tensa of the tympanic membrane).
  • Infectious otitis externa (inflammation of the external auditory canal; e.g., due tomycosis, bacteria (tuberculosis), viruses).
  • Necrotizing osteitis (bone inflammation) of the tympanic ring.
  • Otitis externa haemorrhagica (in viral infections, such as influenza).
  • Reactive otitis externa (inflammation of the external auditory canal), eg:
    • Eczema
    • Psoriasis
    • Seborrheic dermatitis

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Otoliquorrhea – CSF discharge (cerebrospinal fluid; neural fluid) from the ear or external auditory canal (meatus acusticus externus).

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Infection due to foreign body, unspecified
  • Ear cleaning, unspecified
  • Injuries to the ear, unspecified (e.g., perforation of the eardrum: injury caused by foreign bodies, in about two-thirds of cases by cotton swabs (Q-tips); in adolescents between 13 and 18 years of age, in about one-third of cases, trauma during water sports (diving or water skiing))

Operations

  • Paracentesis (stab incision/(making an incision with a scalpel of the tympanic membrane and /or insertion of tympanic drainage/tympanic tubes); possible complication: chronic persistent otorrhea (synonyms: ear discharge, ear discharge).