Bullous myringitis (BM) is a relatively common infectious condition characterized by bullae or vesicles on the tympanic membrane (TM), without affecting the contents of the external or middle ear. If the middle ear becomes involved, this would be consistent with acute otitis media (AOM) and not merely bullous myringitis. As the tympanic membrane is well innervated, moderate to severe pain is a common expected manifestation. Physical findings may be similar to those of acute otitis media, including erythema and thickening of the tympanic membrane, attenuated or absent light reflex, and decrease membrane mobility. Bloody otorrhea can occur when a bulla ruptures and is referred to as bullous hemorrhagic myringitis. The rupturing of bulla often results in a concomitant reduction of pain.
The current thinking is that bullous myringitis is caused predominantly by viruses, although one study insinuated mycoplasma pneumoniae, which was not substantiated by subsequent studies.