Is this actually an Ear Infection? (WARNING - gross description of bodily fluids)

[Thunderpunt]

Firstly I will start by apologising for the possible overuse of the word pus

DS12 came down with what we thought was an ear infection / perforated eardrum about 2 and half weeks ago. GP couldn’t see eardrum but lots of pus and blood (sorry if TMI) so prescribed 5 days Amoxicillin. 5 days later more blood and pus so being the weekend went to out of hours GP - same thing couldn’t see ear drum due to pus so gave another 5 days of Amoxicillin. 5 days later, still more pus so back to GP. Gave clarithromycin which DS has an allergic reaction to, so we are now coming to the end of 7 days of Doxycycline and he still has loads of visible pus in his ear.

Apart from at the very start he really hasn’t had much of a temperature, and not much ear ache recently - although he did for the first 10 days. Unfortunately there is so much pus it’s blocked his ear it’s left him completely deaf (he normally wears hearing aids but can’t due to the muck in his ear, and it’s his better ear affected!)

So am I right to start wondering if this isn’t actually an infection?? In which case, what the bloody hell is causing all this pus?? ( and on 2 occasions blood)

We are waiting on results of ear swabs, hopefully tomorrow. I’m getting to the end of my tether, we fly next week and I could do with it being sorted by then.

Has anyone had anything similar that antibiotics haven’t touched and can shed light on what it could be?

I keep telling him his brain is melting out of his ear from playing too much Fortnite but he’s not falling for it.

Any ideas anyone?

Sorry to hear this is still going on Thunderpunt, neither Doxycycline or Amoxicillin would have been effective for Pseudonomas, this would definitely need Ciproflaxin drops. Usually the acute middle ear infection starts off as a viral or Strep type bacterial infection. Once there is a burst eardrum with prolonged discharge etc., this creates the perfect environment for other bugs such as Pseudonomous or fungi to grow. Fungal growths can take a long time to culture in the lab unfortunately, much longer than most bacteria, and the sensitivities determine which treatment is likely to be effective. This is done in the lab by exposing the growth to different antibiotics or anti fungicides, and observing their effect, so it can take some time.
Unfortunately GPs are often clueless when it comes to matters of the ears, and it sounds like you’ve been poorly prescribed. I do hope this is all resolved soon.

Utis Thank you again for your comprehensive input, your explanation makes so much more sense than anything the GP has said. I'll see how we get on at audiology tomorrow and then sounds like,the consensus is to push for the drops (even if I just have them to take away with us in the event the swab results aren't back before we go, at least I could start them I the hopes they're correct)
Thanks all for your help

@Thunderpunt - ask the clinic to check on the results.

I had this recently, whatever the GP gave me didn't work.

He wanted to refer me but I paid £200 to be seen at Hearology Clinic the next day ( as it was right before xmas and I was totally deaf on one side) so had to have super strong oral antibiotics and stronger drops.

I also had all the gunk microsuctioned out of them which was somewhat painful but so so magical - I could hear immediately

Gentamicin ear drops and Ciprofloxacin 500mg for 10 days 4 times a day by the ENT consultant at Hearology

Christ based on this bnf.nice.org.uk/drug/ciprofloxacin.html I was taking quite a hefty dose...

Snakes I will ask if audiology can see them on there this morning. When the GP surgery look it just says verified. It was when they chased them on Friday and actually spoke to someone that they were told it was to do with the 'sensitivities' (which I didn't understand but do now thanks to PP explanation)

Depending on who you see at the clinic, they might be able to diagnose based on the appearance and smell of the pus. Hopefully they will also be able to prescribe!

Good luck at clinic. I got in this way by going to a&e in the end, after my gp chasing referral didn't work.

Well just seen audiologist who can't do much but ENT clinic is on (well should have started 20 mins ago but consultant only just arrived) so he's going to see if we can be slipped into that. Fingers crossed !

Did you get seen @Thunderpunt ?

Yes - I'm pleased to say we did. She very kindly snuck us in after her first patient.

She microsuctioned a load of pus out, which was both revolting and fabulous
Said we must chase the swabs, but meanwhile she would recommend starting him on eardrops such as the ones mentioned above. She wasn't able to prescribe them as we aren't on her pathway- but suggested I got on to GP to ask them too.

I then tried the Lab directly to see if they could offer any news,but got an answer phone (understandable, imagine having to take those gloves off each time you had to answer the phone!) I did leave a message but stated I was a parent so don't hold out much hope of a call back....

Just tried the GP surgery again for results, nothing back and apparently they have chased too. Now on the call back list to see if GP will prescribe the drops.

Thanks again to everyone for the reassurance - over the weekend I was starting to wonder if I was a completely neurotic mother!

Glad to hear you got seen Thunderpunt, hopefully you’ve had some results by now?
Just a note re a previous post on gentamicin, if there is any perforation, then this wouldn’t be recommended. It’s usually only recommended for external ear infection, but hopefully they have managed to establish that much by now!

@Utis - sadly not much further forward. Swab results still not back, we are on day 2 of the Ciprofloxacin ear drops - nothing has changed yet but it's early days.
Just had a text to say he has an emergency ENT appointment, next Wednesday - also bang in the middle of our holiday 🤦🏻‍♀️
Luckily I called and explained we fly Saturday and they have kindly agreed to fit him in tomorrow. Just means another day off of school... I'll have the LEA attendance officer on my case at this rate!

I was back at the gp with my dd yesterday for another infection. Agreed on a preventative course of antibiotics as prescribed by ENT consultant last year, once acute infection clears (different antibiotic and cipro).

Did his ear pus up again?
I find I need to wipe away gunk to get drops in.

Good luck tomorrow. Surely they should have some results from swab now!!

@CottonSock sorry to hear you were back again as well for DD. His ear hasn't stopped with the pus since the beginning nearly 4 weeks ago, and yes it's a bit of a nightmare to get the drops past it all. Just called GP surgery to chase swabs.... not back. That's 14 days since they were taken.... god knows what bug he's got if they haven't worked it out by now. Maybe it's an undiscovered one and he'll have it named after him

@Utis so sorry to tag you, but now at end of tether.. and you seem to know what you're talking about. GP surgery has just called - they've just heard 'the sensitivities haven't been done' So what the heck have they been doing for 2 weeks? I'm waiting for a call from the duty doctor to see where we go from here but not even sure what else I can do? Presume they are going to ask me to do more swabs.So frustrated I could cry.

Ask them to swab again tomorrow. That's awful

So sorry to hear this. If they haven’t done sensitivity tests, it could be because the growth was anaerobic, and the protocol for running these varies from lab to lab I believe. It has to be specifically requested in some cases, as it’s not as straightforward. If it was pseudonymous, I would expect to see an improvement with these drops after 48 hours or so...but if it’s very profuse discharge it can take a little more time. However if it’s an anaerobic infection, it would need something like Clindamycin. Ask your doctor when they call back. How terribly frustrating for you

And ask them what the culture actually grew, even a generic idea would be helpful!

Well I just saw the duty doctor - and she couldn't really explain why the sensitivities weren't done. She said the culture grew something - Coloform? Chloroform??? And normally they automatically go on to do sensitivities but didn't....

Anyhow, gave me the swab to do on him myself and off to ENT tomorrow - although quite what they can do without results I don't know! But at least we are in the system and hopefully they will be processed properly and we will have some results when we get back.

Meanwhile I have a miserable boy with earache who literally can't hear anything - I just feel so bad for him, poor lad.

I had a similar problem with my DD. She had Otomize ear spray in the end (this was 5+ years ago though) and although it was difficult to find a pharmacy who had it, it worked wonders and quickly too.

Our ENT doc could tell the strain just by looking at it so hopefully this will be the case for you. If I remember the pseudomonous is quite green. Fungal white, I think there are other shades of revolting pus types too.

Ps. Our first swab 2 years ago they told us to treat with chloromapheincol after the sensitivities (sounds a bit like the name you have above), I don't think it worked that well.

Hi Thunderpunt, I’m guessing they meant Coliform? Which is quite a broad group of bacteria, so sensitivities should really have been done. They are largely sensitive to Quinolone antibiotics, of which Ciproflax should work, but of course resistance patterns can and do vary, so there is no way of definitely knowing unless the lab confirm. I do hope you get some better advice today, It must be so frustrating and worrying for you.