There are several conditions that can cause pus and blood in the ear. 1. Conditions in the ear canal. The rupture of a boil in the ear canal may result in pus and blood, which can be seen on examination as a localized protrusion of the ear canal with rupture, while the eardrum is normal or mildly congested. 2. Pus and blood caused by otitis media. The ear pain is usually felt in the early stage, and the ear pain is reduced after the ear bleeds. 3. Swelling in the ear canal. For example, cerumen adenoma in the ear canal or cholesteatoma in the ear canal may also cause pus and blood, and a foreign body embolism or swelling may be seen locally. 4. Swelling in the middle ear cavity, such as a malignant swelling in the middle ear cavity, may cause swelling and stuffiness in the ear, hearing loss, and local pain in the early stage, and pus and blood may appear after a long time, which requires further examination by CT.