What is the cause of left ear pain with hemotympanum (blood coming from the ear)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 28, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Left Ear Pain with Blood

  • Single most likely diagnosis
    • Otitis externa (swimmer's ear) with trauma or infection: This condition is characterized by inflammation of the outer ear canal, which can cause pain and, if severe, lead to bleeding. The presence of blood suggests a possible rupture of the tympanic membrane or significant trauma to the ear canal.
  • Other Likely diagnoses
    • Middle ear infection (otitis media) with perforation: A bacterial or viral infection of the middle ear can lead to the accumulation of fluid and increased pressure, potentially causing the eardrum to rupture, resulting in pain and bleeding.
    • Earwax impaction with bleeding: Sometimes, the attempt to remove earwax can lead to trauma of the ear canal, causing pain and bleeding.
    • Trauma to the ear: Direct injury to the ear can cause pain and bleeding, depending on the severity of the trauma.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Temporal bone fracture: Although less common, a fracture of the temporal bone can cause bleeding from the ear and is a medical emergency due to potential complications involving the brain and cranial nerves.
    • Malignancy (e.g., squamous cell carcinoma of the ear canal): Though rare, cancers of the ear canal can present with pain and bleeding, making early diagnosis critical for treatment and prognosis.
  • Rare diagnoses
    • Relapsing polychondritis: An autoimmune disorder that can cause inflammation and destruction of cartilaginous structures, including those in the ear, potentially leading to pain and bleeding.
    • Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis): A rare autoimmune disorder that can affect various parts of the body, including the ears, and cause a range of symptoms including pain and bleeding.
    • Otosclerosis: A condition characterized by abnormal bone growth in the middle ear, which can cause hearing loss and, in rare cases, might lead to complications resulting in ear pain and bleeding, although this is less common.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.