What is the differential diagnosis for a 25-year-old female presenting with a painful lump behind her left ear?

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Differential Diagnosis for a Painful Lump Behind the Left Ear

Single Most Likely Diagnosis

  • Acute mastoiditis: This condition is an infection of the mastoid bone, which is located behind the ear. It often presents with pain, swelling, and a lump in the affected area, making it a likely diagnosis given the patient's symptoms.

Other Likely Diagnoses

  • Infected sebaceous cyst: A sebaceous cyst can become infected, leading to pain, swelling, and a lump. The location behind the ear is a common site for sebaceous cysts.
  • Lymphadenitis: Inflammation of the lymph nodes, which can be caused by infection or other conditions, can present as a painful lump behind the ear.
  • Furuncle or carbuncle: A furuncle (boil) or carbuncle (cluster of boils) can occur behind the ear, especially if the area is prone to sweating or irritation, leading to a painful lump.

Do Not Miss Diagnoses

  • Mastoid abscess: Although less common, a mastoid abscess is a serious complication of mastoiditis that requires prompt treatment. It can present similarly to mastoiditis but may have additional symptoms like fever and severe pain.
  • Temporal bone osteomyelitis: An infection of the temporal bone, which can spread from nearby structures, is a rare but serious condition that could present with pain and a lump behind the ear.
  • Parotid gland tumor: Although less likely, a tumor of the parotid gland, which is located near the ear, could present as a lump. While most parotid tumors are benign, some can be malignant.

Rare Diagnoses

  • Branchial cleft cyst: A congenital anomaly that can present as a lump along the side of the neck or behind the ear, especially if it becomes infected.
  • First branchial cleft anomaly: Similar to a branchial cleft cyst but can involve the ear and present with a lump or discharge.
  • Eagle syndrome: A condition caused by an elongated styloid process or calcified stylohyoid ligament, which can cause pain in the ear and throat area, though it's less commonly associated with a lump behind the ear.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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