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The table presents a comprehensive guide for the differential diagnosis of discharging ears based on associated factors, potential underlying causes, and key clinical features. It includes a variety of conditions ranging from simple foreign bodies to systemic diseases, aiming to aid primary care clinicians in the timely identification and appropriate management of these cases.
| Associated Factors | Possible Causes and Conditions | Detailed Key Clinical Features |
|---|---|---|
| Blood | Traumatic perforations, tumors | Blood in the external ear canal, possible associated pain, history of injury or prior surgical intervention. |
| Pus | Acute otitis media, infected grommets | Foul-smelling, purulent otorrhoea often accompanied by hearing loss, may have preceding symptoms of ear infection. |
| Cerebrospinal Fluid | CSF leaks | Preceded by a clear history of trauma, may experience headaches, and periorbital or post-auricular bruising. |
| Wax | Keratosis obturans, stenosis | Build-up of wax in the ear canal often leading to otitis externa; may have recurrent episodes. |
| Scanty, Foul-Smelling | Cholesteatoma | Foul-smelling discharge, accompanied by hearing loss, possible facial nerve involvement, and symptoms of vertigo. |
| Postoperative | Grommet-associated discharge | Occurs after grommet placement, otorrhoea may be pus-filled and could coincide with symptoms of acute otitis media. |
| Infected | Otitis Externa | Presents with otalgia, erythema, and oedema of the external auditory canal, discharge is usually... |
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