Differential Diagnosis for Blood in the Ear
- Single most likely diagnosis
- Otitis externa or external ear canal infection: This is a common condition that can cause bleeding due to inflammation and irritation of the ear canal. The use of Q-tips can further irritate the area and cause bleeding.
- Other Likely diagnoses
- Cerumen impaction with bleeding: The use of Q-tips can push earwax deeper into the ear canal and cause bleeding.
- Eustachian tube dysfunction: This can cause fluid buildup in the ear, which may be bloody if there is associated inflammation or infection.
- Basal cell carcinoma or other ear canal tumors: Although less common, these can cause bleeding and should be considered in the differential diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Temporal bone fracture: Although the patient reports no trauma, it is essential to consider this possibility, as it can be life-threatening if not promptly diagnosed and treated.
- Malignant otitis externa: This is a severe infection that can occur in diabetic or immunocompromised patients and can be life-threatening if not promptly treated.
- Jugular bulb abnormality: An abnormality of the jugular bulb, such as a thrombosis or aneurysm, can cause bleeding in the ear and is a potentially life-threatening condition.
- Rare diagnoses
- Hemangioma or other vascular malformations: These are rare conditions that can cause bleeding in the ear.
- Granulomatosis with polyangiitis (GPA) or other autoimmune disorders: These conditions can cause inflammation and bleeding in the ear, although they are rare and would require further evaluation to diagnose.