Differential Diagnosis for Blood Coming Out of Ear

• Single Most Likely Diagnosis
  • Trauma to the ear: This is the most likely diagnosis as it can cause a laceration or rupture of the eardrum, leading to bleeding from the ear. The trauma could be due to a direct blow to the ear, a fall, or an object inserted into the ear canal.
• Other Likely Diagnoses
  • Middle ear infection (otitis media): A severe infection can cause the eardrum to rupture, resulting in bleeding. This is more common in children but can occur in adults as well.
  • Ear canal infection (otitis externa): Also known as swimmer's ear, this infection can cause inflammation and sometimes bleeding, especially if there is a rupture of the skin in the ear canal.
  • Mastoiditis: An infection of the mastoid bone, which is located behind the ear. In severe cases, it can lead to complications that cause bleeding from the ear.
• Do Not Miss Diagnoses
  • Basilar skull fracture: This is a serious condition that can cause bleeding from the ear due to a fracture in the base of the skull. It's crucial to identify this condition promptly as it can have severe complications.
  • Cerebrospinal fluid (CSF) leak: If there's a fracture in the skull that affects the membranes surrounding the brain, it can lead to a leak of CSF, which might be mistaken for blood or could be mixed with blood.
  • Vascular malformation or tumor: Although rare, a vascular malformation or a tumor in the ear or skull could cause bleeding. These conditions require immediate medical attention.
• Rare Diagnoses
  • Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation of the cartilage in the ear, potentially leading to bleeding.
  • Wegener's granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect various parts of the body, including the ears, and cause bleeding due to inflammation of the blood vessels.
  • Otosclerosis: A condition that affects the middle ear, causing hearing loss. In rare cases, it might lead to bleeding, although this is extremely uncommon.