Bullous Myringitis

What is bullous myringitis?

Bullous myringitis (BUH-lus myr-in·GI-tis) is an infection that causes painful blisters on your eardrum. Healthcare providers may also refer to bullous myringitis as bullous hemorrhagic myringitis and fungal myringitis. You can develop bullous myringitis if you have a cold or an ear infection (acute otitis media). The condition typically affects children ages 5 to 8 but can affect younger children and adults.

What are bullous myringitis symptoms?

Symptoms of bullous myringitis include:

• Severe ear pain that comes on suddenly.
• Fever.
• Poor appetite.
• Trouble sleeping.
• Hearing loss.
• Fluid draining from your ears.

What causes bullous myringitis?

You develop bullous myringitis when viruses or bacteria infect your eardrum. Your eardrum reacts to infection by becoming irritated or inflamed, creating small, fluid-filled bullae between your eardrum’s middle and outer layers.

The same bacteria or viruses that cause colds and related middle ear infections cause bullous myringitis. Studies suggest that respiratory syncytial virus (RSV) and other viruses cause most cases of bullous myringitis, but bacteria — including Streptococcus pneumoniae (pneumococcus) and mycoplasma— may also cause the condition.

Do acute middle ear infections always cause bullous myringitis?

No, they don’t. One study suggests about 10% of children with acute middle ear infections developed bullous myringitis.

What are the complications?

Some temporary hearing loss is the most common complication. Rarely, people with bullous myringitis may develop other conditions, including:

• Labyrinthitis.
• Meningitis.
• Mastoiditis.

How is bullous myringitis diagnosed?

A healthcare provider will use an otoscope to look for blisters on your eardrum. They may order a pure-tone hearing test to evaluate any hearing loss.

What is a pure-tone hearing test?

A pure-tone hearing test is the most common type of hearing test. Audiologists perform hearing tests, including pure tone hearing tests. Here’s how it works:

1. You sit in a sound-treated room.
2. You wear headphones or insert earphones.
3. The audiologist uses a machine called an audiometer. Audiometers deliver sounds at different frequencies and loudness levels.
4. You raise a hand, press a button or say “yes” when you hear sounds.
5. The audiologist records your responses on an audiogram. Audiograms chart your hearing loss patterns. If you have hearing loss, the audiogram shows the degree of hearing loss you have.

How is bullous myringitis treated?

Treatments may include:

• Pain medication.
• Decongestants.
• Antibiotics.

Providers may use a small, sharp knife to drain the blisters.

How long does this condition last?

Most people feel better within 24 to 48 hours after starting treatment.

How can I lower my risk of bullous myringitis?

The best way is to protect yourself and your child from colds and ear infections. You may not be able to dodge every cold and ear infection, but the following suggestions may help:

• Wash your hands. Cold viruses spread from your hands to your eyes, nose and mouth. Handwashing is one of the best ways to keep cold viruses from spreading.
• Clean frequently used surfaces. Viruses can live on doorknobs and other places people often touch.
• Use hand sanitizers. Use alcohol-based hand sanitizer when you can’t wash your hands with soap and water.
• Strengthen your immune system. Get enough sleep, eat a healthy diet and exercise so your body is ready to fight off germs.
• Stay home. To make sure you don’t spread the cold to others, stay home when you’re sick and keep your children home from school or daycare if they’re sick.
• Don’t smoke. Studies have shown that exposure to secondhand smoke increases the likelihood of ear infections. Be sure no one smokes in the house or car — especially when children are present — or at your daycare facility.
• Manage allergies. Inflammation and mucus caused by allergic reactions can block your eustachian tube and make ear infections more likely. Ear infections increase your chance of developing bullous myringitis.
• Get vaccinations. Being vaccinated against viral infections and other infections may reduce your risk of colds that could lead to bullous myringitis.

What’s the prognosis for bullous myringitis?

Treatment quickly cures bullous myringitis. Studies show 95% of people feel better within 24 to 48 hours of treatment.

How do I take care of myself?

Treatment, including pain medication and antibiotics, helps most people feel better within a day or two. Sometimes, placing a warm compress on the outside of your ear also helps with ear pain.

When should I see my healthcare provider?

Contact your provider if your symptoms continue or get worse after treatment.

What’s the difference between bullous myringitis and a middle ear infection?

Ear infections happen when bacteria or viruses infect and trap fluid behind your eardrum, making it bulge or swell and hurt. Bullous myringitis doesn’t cause the same fluid buildup as a middle ear infection. Instead, viruses or bacteria infect your eardrum.

A note from Cleveland Clinic

Bullous myringitis is a type of ear infection that causes painful blisters on your eardrum. It may happen if you have a cold or a middle ear infection. Unlike middle ear infections, bullous myringitis doesn’t make your eardrum bulge or swell or your ears ache. Instead, bullous myringitis causes sudden severe ear pain. It can affect hearing. Fortunately, treatment quickly eases ear pain and restores hearing.