Differential Diagnosis for 8-year-old Female with Left Ear Pain
- Single most likely diagnosis
- Otitis Externa (Swimmer's Ear): This is the most likely diagnosis given the patient's recent swimming activities and the onset of ear pain after starting swimming lessons. Otitis externa is an inflammation of the outer ear and ear canal, often caused by bacterial or fungal infections, which can be exacerbated by moisture.
- Other Likely diagnoses
- Acute Otitis Media: Although the patient denies fever, nasal congestion, cough, or rhinorrhea, acute otitis media (middle ear infection) is still a possibility, especially if the patient has had a recent upper respiratory infection that has resolved.
- Eustachian Tube Dysfunction: This condition, which affects the tube that connects the middle ear to the back of the nose and throat, can cause ear pain and is common in children, especially after activities that involve changes in air pressure, such as diving or swimming.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant Otitis Externa: A rare but serious complication of otitis externa, especially in diabetic or immunocompromised patients. Although the patient does not have mentioned risk factors, it's crucial to consider due to its potential severity.
- Mastoiditis: An infection of the mastoid bone in the skull, located behind the ear, which can be a complication of untreated or severe otitis media. It requires prompt medical attention to prevent serious complications.
- Rare diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation of the cartilage in the ears, among other areas. It's unlikely but could be considered if the patient has recurrent episodes of ear pain without a clear infectious cause.
- Ear Canal Foreign Body: Although less likely given the history of swimming, it's possible that an object (like a bug or a small toy) could have entered the ear canal, causing pain. This would typically present with more acute onset and possibly visible signs of a foreign body.