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Bullous myringitis: Causes, symptoms & treatment

Last update on Apr, 08, 2024

Bullous myringitis is an ear infection that causes severe pain and hearing loss. Learn about its causes and symptoms, as well as strategies for treating and preventing this painful infection.  

What is bullous myringitis?

Bullous myringitis is an ear infection that causes painful blisters on the eardrum (the thin tissue that separates the outer ear and middle ear) and can lead to temporary hearing loss. While bullous myringitis typically affects children ages 5 to 8, it can also develop in adults. Bullous myringitis can cause severe ear pain but resolves quickly when treated with pain medication and antibiotics. In fact, most people report feeling better within 24 to 48 hours of starting treatment.  

What does bullous myringitis look like?

If you have bullous myringitis, you won’t see any visible signs of it outside your ear. However, using an otoscope, a doctor will be able to identify a clear or reddish blister or two on your eardrum. The blisters are often painful and may drain fluid. 

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What causes bullous myringitis?

Bullous myringitis is caused by the same bacteria or viruses that cause colds and middle ear infections (acute otitis media). In fact, you can develop these conditions together. While most cases of bullous myringitis are caused by viruses such as respiratory syncytial virus (RSV), the infection can also be caused by bacterial strains such as Streptococcus pneumoniae and mycoplasma.

When bacteria or viruses infect your eardrum, the tissue reacts by getting irritated or inflamed, forming small, fluid-filled blisters between the middle and outer layers of your eardrum.

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What are symptoms of bullous myringitis?

Common symptoms of bullous myringitis include sudden, severe ear pain and hearing loss. Rest assured, bullous myringitis hearing loss is only temporary—your hearing returns once the infection is treated. Other bullous myringitis symptoms include:

How is bullous myringitis diagnosed?

To check for a bullous myringitis diagnosis, your doctor will look for blisters on your eardrum using an otoscope, a handheld tool that shines a light inside your ear. They may also give you a hearing test to evaluate hearing loss. 

Bullous myringitis treatment

Bullous myringitis treatment often includes oral antibiotics or ear drops containing antibiotics, plus oral corticosteroids. This combination will control the infection and reduce pain and inflammation. In children, amoxicillin is often prescribed as a first course of treatment. Your doctor may also drain the eardrum blisters using a lancet to relieve pain.

Most people feel better within 24 to 48 hours of starting bullous myringitis treatment. Because dampness can prolong the infection, keeping the ears dry during treatment is essential. Your doctor may recommend wearing earplugs while showering and avoiding swimming.    

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How can I prevent bullous myringitis?

Prioritizing a healthy immune system to avoid getting a cold, respiratory infection or ear infection is the best way to prevent bullous myringitis. Make sure you get enough sleep, stay hydrated and prioritize healthy foods and exercise. Since ear infections are caused by bacteria and viruses, basic hygiene practices like handwashing are also key for bullous myringitis prevention and ear infection prevention.

Wash your hands (or use an alcohol-based hand sanitizer if soap and water aren’t available) after using the toilet or changing diapers; blowing your nose; touching animals; treating cuts and sores; and before, during and after preparing food. Clean high-traffic surfaces like doorknobs and countertops, and stay home (or keep your kids home) if sick.

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Experiencing symptoms of myringitis?

If you’re noticing symptoms of bullous myringitis, visit your doctor.

FAQs on bullous myringitis

Bullous myringitis itself isn’t contagious, but the bacteria or viruses that cause it are and they often spread among children between the ages of 5 and 8. To prevent bullous myringitis, follow basic hygiene practices like regular handwashing, cleaning frequently used surfaces and staying home when sick. Keeping your immune system healthy can also help stave off infections.

Pain from bullous myringitis comes on suddenly. People typically seek treatment after two to three days and experience pain relief within 24 to 48 hours after starting treatment. Other symptoms, including fever and hearing loss, tend to resolve soon after. 

Both bullous myringitis and middle ear infections are caused by the same bacteria or viruses. A middle ear infection occurs when the eustachian tube that runs from the middle of your ear to the back of your throat gets blocked, causing fluid to get trapped behind your eardrum. This can lead to infection, causing painful swelling. Bullous myringitis, on the other hand, doesn’t make your eardrum swell. Instead, it causes painful blisters

Bullous myringitis is most common in children ages 5 to 8. However, it can happen to anyone who gets exposed to bacteria or viruses that cause eardrum infections. Bullous myringitis can develop from colds or acute middle ear infections, though not often—research suggests it only occurs about 10% of the time. 
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