Bullous myringitis hemorrhagica

A type of ear infection

Bullous myringitis hemorrhagica is an acute otitis media characterized by the presence of hemorrhagic bullae on the tympanic membrane. This condition is a variant of myringitis, which involves inflammation of the eardrum.

Pathophysiology

Bullous myringitis hemorrhagica is caused by a viral or bacterial infection that leads to the formation of fluid-filled blisters on the tympanic membrane. The most common pathogens associated with this condition include Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. The infection results in inflammation and the accumulation of serous or hemorrhagic fluid within the bullae.

Clinical Presentation

Patients with bullous myringitis hemorrhagica typically present with sudden onset of severe otalgia (ear pain), which may be accompanied by hearing loss and tinnitus. The pain is often more intense than that experienced in typical cases of otitis media. On otoscopic examination, the presence of hemorrhagic bullae on the tympanic membrane is a distinguishing feature.

Diagnosis

The diagnosis of bullous myringitis hemorrhagica is primarily clinical, based on the characteristic appearance of the tympanic membrane during otoscopic examination. Audiometry may be used to assess the degree of hearing loss. In some cases, tympanometry can help evaluate the mobility of the tympanic membrane.

Treatment

Diagram of ear anatomy

Treatment of bullous myringitis hemorrhagica involves addressing the underlying infection and managing symptoms. Analgesics such as acetaminophen or ibuprofen are commonly used to alleviate pain. If a bacterial infection is suspected, antibiotics may be prescribed. In cases where the bullae cause significant discomfort or do not resolve, myringotomy may be performed to drain the fluid and relieve pressure.

Prognosis

The prognosis for bullous myringitis hemorrhagica is generally good, with most patients experiencing complete resolution of symptoms with appropriate treatment. Complications are rare but may include tympanic membrane perforation or persistent conductive hearing loss.

Prevention

Preventive measures for bullous myringitis hemorrhagica include vaccination against common pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. Good hygiene practices and avoiding exposure to respiratory infections can also reduce the risk of developing this condition.

Related pages

• Otitis media
• Myringitis
• Tympanic membrane
• Hearing loss