A friend has had an ear infection for more than 15 years with a foul odor, bloodstains, and hearing difficulty. What could it be?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern. The possible reason for these symptoms is a bone-eating disease called cholesteatoma, in which the ear bones get eroded and infected with a discharge, hence having an unpleasant odor and can leave blood stains. When detected and treated appropriately, this is a treatable condition, so seek medical help at the earliest. 1) I suggest you get an HRCT (high resolution computed tomography) temporal bone scan to rule out an epidural abscess (infection in the space between the skull bones and brain lining) which is the most common condition in patients with such issues in addition to chronic headaches. 2) Please refrain from using earbuds as it further introduces the infection and makes it even worse. 3) Please seek medical help as soon as possible. This has to be viewed seriously, as the bone erosion spreads and can reach vital brain areas, causing severe intracranial (within the skull) complications. I hope this helps. Kindly revert for further queries.

Hi,

Welcome back to icliniq.com.

I will be able to guide you better if you could send me images of the infection. 1) The green discharge is mainly due to the presence of pseudomonas aeruginosa (a gram-negative aerobic bacteria), which causes secondary infection (an infection that occurs during or after treatment of another infection). 2)The primary management of cholesteatoma is surgery, and conservative management is just meant to reduce the intensity of the infection and thereby reduce the rate of progression of the disease. I would suggest starting with tablet Ciplox-TZ (Ciprofloxacin and Tinidazole) twice a day or tablet Augmentin 625 mg (Amoxicillin 500 mg and Clavulanic Acid 125 mg) thrice a day after food for 10 days as conservative management and will see how the response is. However, tablet Ciplox-TZ would be my first preference. 3)Make sure he does not clean his ears on his own, which will attract unnecessary infection. 4) I can recommend if anything more could be added after looking at the images of the infected site. Revert for further queries.

Hi,

Welcome back to icliniq.com.

1)Check for tablet Ciplox-TZ in a medical outlet store; if not, I am sure tablet Augmentin 625 mg would be available over the counter; make sure one of the antibiotics is started. In addition, 2% Acetic Acid ear drops should be used by starting with three drops, three times a day for the next 10 days. As I said, medications are just meant to buy time and reduce the load of the current infection and not to entirely stop the disease from spreading. 2) I suspect cholesteatoma, considering the presence of the disease for such a long time, if let alone and if the rate of progression of the disease is fast, it definitely can become a life-threatening condition, and that is why we prefer to get an HRCT scan done as soon as possible. 3)Please do not panic and share the images at the earliest so that I can see and mention whatever has to be done. For now, I guess these two medications will be of help.