Differential Diagnosis for a 26-year-old Female with Mild Fever, Neck Pain, and Ear Pain
- Single most likely diagnosis:
- Pharyngitis (e.g., streptococcal or viral): This is a common condition that can cause neck pain, ear pain (referred pain), and mild fever. The symptoms presented are typical for this diagnosis.
- Other Likely diagnoses:
- Otitis media: An infection of the middle ear that can cause ear pain and, if severe, can lead to fever and neck pain due to referred pain or involvement of surrounding structures.
- Tonsillitis: Similar to pharyngitis, tonsillitis can cause pain in the throat, which may radiate to the ears and be accompanied by fever.
- Cervical lymphadenitis: Inflammation of the lymph nodes in the neck can cause neck pain and fever, and if the infection is related to an ear or throat condition, it could also explain the ear pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis: Although less common, meningitis is a serious condition that can present with fever, neck pain (due to nuchal rigidity), and sometimes ear pain if there's associated cranial nerve involvement. It requires immediate medical attention.
- Lemierre's syndrome: A rare but serious condition involving a bacterial infection of the throat that spreads to the jugular vein, causing sepsis. It can present with neck pain, fever, and sometimes ear pain.
- Temporal arteritis (giant cell arteritis): While more common in older adults, this condition can cause fever, neck pain, and jaw or ear pain due to inflammation of the blood vessels. It's a medical emergency due to the risk of vision loss.
- Rare diagnoses:
- Mastoiditis: An infection of the mastoid bone in the skull, which can cause ear pain, fever, and neck pain due to its proximity to these areas.
- Petrous apicitis: A rare condition involving infection of the petrous part of the temporal bone, which can cause severe ear pain, fever, and sometimes neck pain.
- Eagle syndrome: A condition where an elongated styloid process or calcified stylohyoid ligament causes pain in the ear, face, and neck, which can be exacerbated by swallowing and may be accompanied by fever if there's an associated infection.