Differential Diagnosis for 11-year-old Boy with Rash and Ear Pain
- Single most likely diagnosis:
- Parotitis (Mumps): The pain in the back of the ear, especially when eating, and the recent fever suggest parotitis, which is commonly caused by the mumps virus. The rash on the chest could be unrelated or a viral exanthem.
- Other Likely diagnoses:
- Viral exanthem with referred ear pain: The rash and skin peeling could be part of a viral illness, and the ear pain might be referred from another source, such as a sore throat or temporomandibular joint (TMJ) pain.
- Otitis externa (External Ear Infection): Although the external ear canal appears normal, otitis externa could still be a possibility, especially if the pain is localized to the back of the ear.
- Temporomandibular joint (TMJ) disorder: TMJ pain can radiate to the ear and be exacerbated by eating or jaw movement.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Mastoiditis: This is a serious infection of the mastoid bone, which can occur as a complication of otitis media (middle ear infection). It requires prompt medical attention to prevent serious complications.
- Lyme disease: Although less likely, Lyme disease can cause a rash (erythema migrans) and later stages can involve neurological or joint symptoms, including ear pain.
- Sjögren's syndrome: This autoimmune disorder can cause parotid gland swelling and ear pain, but it is rare in children.
- Rare diagnoses:
- Relapsing polychondritis: This rare autoimmune disorder can cause cartilage inflammation, including the ears, and might present with ear pain and a rash.
- Sarcoidosis: This condition can cause inflammation in various parts of the body, including the ears, but it is rare in children.
- Tuberculosis (TB): TB can cause a variety of symptoms, including ear pain and a rash, but it is relatively rare in immunocompetent children.