What can this be if not an infection?

[OhLookHeKickedTheBall]

Posting here for traffic. I'll try to get as much in so I'm not drip feeding.

Dd (8) has had recurrent issues with glue ear and infections for most of her life. 3 years ago she had grommets inserted which mainly seemed to help. 2 years ago she had an mrsa infection in her left ear (right grommet had come out by that time naturally, left still there at that point - it's very recently come out on its own). Since then she's had a few minor infections, a staph infection and a couple of nasty skin infections in that ear.

So here we are again, for the last 4 weeks her ear has been discharging again. Amoxicillin helped in that the ear isn't discharging constantly, but does every few days for a few days, then takes a break, etc. Gp says no infection but took swab. Swab showed mrsa present. Sent to ENT on weds who were sure she has no infection, prescribed steroid drops for redness and swelling and said as it's not discharging not to worry. I did say it was discharging, the gp had seen it that morning too and the consultant shrugged and sent us on our way.

Her ear started discharging again on Saturday and had been going since.

I've tried google, but basically everything points me to ear discharge being down to an infection. Anyone have any idea what this may be if her ear isn't infected? She isn't unwell in herself and has no temperature but is sometimes out of sorts - this is relatively typical behaviour for her when she gets infections. She's complaining a lot of itching, she rarely ever complains of pain (we suspect she's more used to being in pain in the ears than not anyway).

I thought that's what grommets did, let fluid drain away without building up?

DS has frequent ear infections, sometimes the infections were fungal, sometimes bacterial, but swabs need to be checked for a range of bacteria. Staph and Strep A infections can be present and are difficult to fully clear as they are bacteria that are present in most people and can quickly flare given the right environment. ENT consultants would insist that his ear infections always started with nasal congestion which spread. He had nasal steroid drops and well as low level antibiotics and usually had antibiotic ear drops to clear ear infections. We eventually went down the route of functional medicine and food exclusion which has improved his over all health though he is still prone to throat infections, his ear infections have stopped.

In our case a tonsiladenoidectomy. But in with ear infections were throat infections and the adenoids were extremely large. Adenoids only possible to know once inside btw - ENT suspected but couldn't know for certain until actually operating. So my guess would be adenoids need severe trimming. (As tonsils not picked up as being problematic)

OP look up 'otitis media with effusion'- you can get discharge without it being infected.

Just to clarify this is yellow and brown thick sticky pus with a very offensive smell. She had an adenoidectomy when grommets were put in, but they decided to leave tonsils as they hadn't been getting infected like her ears. They are larger than other kids and in fairness one thing that's occurred with this lot of discharge is often her right tonsil enlarges above the normal largeness, but then returns back. One gp suggested that possibly the drainage was coming from the tonsils through the ear, but other gp and ENT suggested that was not right. She does appear to be mouth breathing more again so perhaps it is tonsil related.

I really want to go back to the GP and ENT with some idea as I don't want to be fobbed off again, and school aren't particularly happy with with this happening over and over.

And thank you all for responding btw

Right, if her tonsils are always large, then that is what I was like as a child. One cold drink and I had a sore throat, once icecream - sore throat, got a slight chill - sore throat. But the sore throats were not enough to be tonsillitis under the normal criteria, but they constantly affected me. I also had bouts of tonsillitis occasionally, and they were absolute doozies, the body aches were right up there with a severe flu. Wouldn't eat or drink for a week at a time. My DM battled for years to treat me (but was personally against tonsillectomy), I was on antibiotics for almost half a year one year at one point.

In the end I had them removed in my 20s after being fed up with the situation. The operation is hell on earth for an adult, btw. As a result of them being removed as an adult, I had begun to have significant chest infections as well. After removal I was on antibiotics every winter for a chest infection for 3 years. After that I decided to just fight it, and battled through the infection without antibiotics. The following year the chest infection was reduced in severity, and again the following year. By the 4th year, I was fine.

My body had no ability to fight infections on its own, and needed a lot of time without antibiotics to heal and regain the ability to fight illnesses.

I suspect your DD's enlarged tonsils are a low level infection. Take your DD's temperature 3 times a day, continuously, and keep a track of them. She might be having slight variations in her temperature that fall within the 'normal' range, but the fluctuations might be indications that her body is constantly fighting a low level infection.

Also keep a health diary for her. When she looks run down, whether she complains of any aches etc, and how often she is getting the discharge. (Take photos of the discharge as well).

Oh and I only had slight discharge from my ears, but did suffer a perforated ear drum a few times as a result of it all.

Thanks hypatia. I had my tonsils removed as a young child due to recurrent tonsillitis so the world of tonsils is quite new to me. I have a GP appt for her today, they aren't impressed the ENT consultant shrugged me off with no advice on what to do if the ear started discharging again nor that I wasn't taken seriously on it when they had seen it on weds so I imagine they will be referring me back to ENT. I'll ask them properly about whether this could be tonsil related or ask them put that as a query to ENT.

I have photos of some of this weekends occurrence. And some of previous times too.

I wouldn't be so fussed if anyone said this is probably x and it will likely clear up in y time but if not bring her back. But so far I'm just getting told her ear isn't infected but no response on why it's discharging the way it is other than a repeat of it's not infected. I obviously don't want her on antibiotics if they aren't necessary, but there is definitely something not right here. Fwiw her right ear never did anything like this at all after the grommet insertion or when the grommet came out or even since.

This was me when I was a kid.

I had that coming from my ears for weeks and weeks.
Eventually medication did work. I was a child so I don't know why it went on for so long but I do remember that meds fixed it in the end. The description is exactly how you said.
I had grommets as well.

Poor kid.

How long ago was the swan taken?

I've just remembered I had it as an adult as well and that went on for 8 weeks.
It was an prescription spray that worked in the end. I think it might have been fungal I can't remember.
Ducking awful though.

I had exactly the same symptoms last year OP and unfortunately I ended up needing an operation to remove the infection because it had spread to the mastoid bone behind my ear. I had recurrent, foul smelling discharge from my ear, which was a staph infection and had many antibiotic drops and oral medication, all of which did nothing to get rid of the infection.

I had the same operation on my other ear 20 years ago as a teenager, which followed on from glue ear, grommets and and having my adenoids removed as a young child.

I would definitely keep pushing for further investigation as it can become serious if the infection spreads to the mastoid bone.

If it's thick and sticky and foul then yes it does sound like an infection. -it could be mastoiditis so make sure you mention that. Also adenoids can grow back even if they've been removed so that's something to consider if the symptoms are the same as previous. Hope you get some answers.

Got a great result at the GP. Managed to see the best one at the practice, not sure how that happened as she's usually mega booked. I think she may have taken the ENTs actions on Weds personally against the practice as the GP we saw that day had told ENT they saw clear signs of infection when they referred her, she was not happy at all that they said it wasn't infected. In her words DDs ear is clearly infected and has been for the last 4 weeks, it may not be the worst infection they've ever seen but it's obvious enough. We have antibiotics, antifungals and drops prescribed plus a follow up next week and if the ear hasn't cleared DD is being sent for a scan to rule out mastoid infection.

She thinks DDs tonsils are reacting to the ear and not the other way around though when we go for the next routine ENT appointment I will bring those up. Will keep a note of her temperatures too.

And again, sorry to keep forgetting to say this, thank you all for responding.

Also adenoids can grow back even if they've been removed so that's something to consider if the symptoms are the same as previous.
Aaahh I had no idea, I really hope this isn't the case but I will also mention on the next appointment

Very glad to hear your GP is kicking butt.

Sounds like she is being very thorough with the infection now.
Hopefully it hasn't gone further and she will feel some relief very soon.