Differential Diagnosis for Recurrent Left Ear Pain
- Single most likely diagnosis
- Recurrent otitis externa: This is the most likely diagnosis given the patient's history of otitis externa and the fact that symptoms worsen after water exposure. Otitis externa is an inflammation of the outer ear and ear canal, often caused by bacterial or fungal infections, and is commonly seen in individuals who are frequently exposed to water.
- Other Likely diagnoses
- Eustachian tube dysfunction: This condition can lead to middle ear problems, including ear pain, and is a plausible alternative diagnosis. The Eustachian tube helps to regulate air pressure in the ear, and dysfunction can cause discomfort and pain.
- Middle ear effusion: This condition, where fluid accumulates in the middle ear, can also cause ear pain and is a possible alternative diagnosis. Middle ear effusion can be a complication of eustachian tube dysfunction or other conditions.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant otitis externa: Although rare, this condition is a serious and potentially life-threatening complication of otitis externa, particularly in individuals with compromised immune systems. It requires prompt diagnosis and treatment to prevent serious consequences.
- Cholesteatoma: This is a type of skin cyst that can occur in the middle ear and mastoid, potentially causing serious complications, including hearing loss and neurological problems, if left untreated.
- Rare diagnoses
- Other conditions such as temporomandibular joint (TMJ) disorder, trigeminal neuralgia, or referred pain from other sources (e.g., dental problems) could also cause ear pain, but are less likely given the patient's history and symptoms. These conditions would require further evaluation and diagnostic testing to confirm.