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If your ear has been leaking pus for several weeks, you may have a long-term (chronic) infection of the ear, which has made a hole in your eardrum.

You can get a long-term ear infection if you have a short-term (acute) infection that doesn't completely clear up.¹

The tube leading into your ear is called your ear canal. Stretched across the inner end of your ear canal is your eardrum. Your eardrum vibrates when sound waves reach it. Your brain turns sound waves into sounds that you can hear.

Ear infections can make a hole in your eardrum. Doctors call this a perforation. If you have an infection, you can get swelling and a build up of fluid in your middle ear. Your middle ear is the part of your ear behind your eardrum. The pressure of the fluid in your middle ear can make a hole in your eardrum.

Some people get a hole in their eardrum for other reasons: for example, from hearing a very loud noise. They can then get a long-term infection as a result of the hole.¹ This is because your eardrum acts as a barrier to stop germs (bacteria) from going into your middle ear. But when your eardrum has a hole in it, bacteria can easily get into your middle ear.

If you have ear infection with discharge, you'll get pus coming out of your ear. It might go away for a while and then come back. If you have had pus coming from your ear for more than two weeks, you have a long-term infection. Doctors call this chronic otitis media.

Some people get holes in their eardrum that are not infected and rarely leak pus. And some people get an ear infection without having a hole in their eardrum. But these are different kinds of problems and are treated differently.

Ear infections happen to adults and children. But they're more common in children. That's because their ear canals are shorter, so it's easier for germs to get inside and cause an infection.

We don't know for sure why some people get long-term ear infections with discharge. But there are some things that make it more likely. These are called risk factors. They include:^{2 3 4}

• Getting a lot of infections like colds and coughs
• Living in overcrowded housing
• Poor hygiene: for example, not having clean water for washing and cleaning
• Eating a poor-quality diet.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.