Differential Diagnosis for Camden's Ear Pain
Single Most Likely Diagnosis
- Acute Otitis Media (AOM): This is the most likely diagnosis given Camden's symptoms of ear pain, decreased hearing, and tenderness to touch. AOM is a common condition in children, and the absence of other symptoms such as fever, cough, or nasal congestion does not rule out this diagnosis.
Other Likely Diagnoses
- Otitis Externa: Also known as swimmer's ear, this condition is characterized by inflammation of the outer ear canal, which could cause pain, especially when touching the ear. The lack of symptoms such as itching or discharge does not entirely rule out this diagnosis.
- Earwax Impaction: This could cause decreased hearing and discomfort, although it might not fully explain the pain upon touching the ear unless the impaction is significant and causing irritation.
- Middle Ear Effusion: This condition, where fluid accumulates in the middle ear, can cause hearing loss and might be associated with some discomfort, although it typically does not cause severe pain.
Do Not Miss Diagnoses
- Mastoiditis: Although less common and typically associated with more severe symptoms such as fever and headache, mastoiditis is a serious condition that can arise from untreated or inadequately treated AOM. It requires prompt recognition and treatment to prevent complications.
- Petrous Apicitis: A rare but serious complication of otitis media, characterized by infection of the petrous part of the temporal bone. It can present with severe ear pain and neurological symptoms, although the latter are not mentioned in Camden's case.
- Ramsay Hunt Syndrome (Herpes Zoster Oticus): This condition, caused by the varicella-zoster virus, can lead to ear pain, hearing loss, and facial paralysis. Although Camden's age and lack of rash make this less likely, it's a condition not to be missed due to its potential for significant morbidity.
Rare Diagnoses
- Cholesteatoma: An abnormal skin growth in the middle ear behind the eardrum, which can cause hearing loss and discomfort. It is less common in children and typically associated with a history of recurrent ear infections or ear trauma.
- Eustachian Tube Dysfunction: While more common in adults, this condition can cause ear fullness, hearing loss, and discomfort due to problems with the tube that regulates air pressure in the ear. It might not fully explain the acute onset of severe pain but could be considered if other diagnoses are ruled out.
- Relapsing Polychondritis: A rare autoimmune disorder that can cause cartilage inflammation, including in the ears, leading to pain, redness, and hearing loss. The absence of other systemic symptoms makes this diagnosis less likely.