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

Answered by
Dr. B. Vageesh Padiyar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 11, 2022

Hello doctor,

One of my close ones has had an ear infection for more than 15 years. He underwent surgery for the same, which involved clearing the infected bone from the back of the ear, and was advised to get a device or an implant which I am not sure of, to aid hearing, but he failed to follow up. He got the infection yet again with a foul odor from it. He wakes up with blood spots on his pillow and gets blood stains while using earbuds. He has hearing difficulty as well and constantly complains of a headache. He is taking medications for cholesterol, high blood pressure, and antidepressants. What could this be?

Please help.



Welcome to

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.

Hello doctor,

Thank you for the reply.

He has had this infection now for more than 15 years. What is the chance it has not affected other parts of his body? When I looked into his ears through a camera, it seemed green. I am concerned.

Please help.



Welcome back to

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.

Hello doctor,

Thank you for the reply.

Where can I get tablet Ciplox TZ? And I am concerned if this is a life-threatening condition? I will send you the pictures at the earliest.



Welcome back to

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.

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