Clinical Case Database / Category: Case Based Discussion

Management of the discharging ear

Publication details

Raad John Glore MD MRCS DOHNS, John O’Callaghan MBBS BSc, David Bowdler MBBS FRCS
Foundation Years Journal, volume 2, issue 2, p.86 (123Doc Education, London, February 2008)


A 6-year-old boy presented to his GP with a 24-hour history of left ear discharge. His mother said that he suffered with a common cold 10 days previously and that a few days later his teacher noticed he was not paying attention in class. Two days prior to presentation he started complaining of left earache, reduced hearing and fever which responded to paracetamol. On the morning of presentation she noticed some blood and pus on his pillow. The child said that the earache had settled. The ear, nose and throat (ENT) examination revealed a left purulent otorrhoea with central perforation and an inflamed tympanic membrane. Rinne’s tuning fork test was negative on the left side whilst the Weber’s test localized to the left. The rest of the examination was unremarkable. The patient was treated conservatively for acute otitis media with analgesia and his mother was asked to ensure his left ear was kept dry for 2 weeks until review.

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Raad John Glore MD MRCS DOHNS

Senior SHO ENT
University Hospital Lewisham

John O’Callaghan MBBS BSc (Corresponding author)

ENT department
Lewisham Hospital
Lewisham High Street
SE13 6LH

David Bowdler MBBS FRCS

Consultant ENT
University Hospital Lewisham


1. Graham JM, Scadding JK, Bull PD. Pediatric ENT 1 st Edition. Springer 2007.
2. Chapters 41–43, Roland NJ, McRae RDR, McCombe Aw. Key Topics in Otolaryngology 2nd Edition. BIOS Scientific Publishers 2002. pp 5–7, 35–41.
3. Jafek BW, Murrow BW. ENT Secrets 2nd Edition. Hanley & Belfus 2001. pp 53–73.
4. Chapter 3 In Scott-Brown’s Otolaryngology, Volume 3, 6th Edition.


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