Differential Diagnosis for 13-year-old Girl with Left Ear Pain and Bloody Drainage
- Single Most Likely Diagnosis
- Otitis Externa (Swimmer's Ear): This is the most likely diagnosis given the symptoms of ear pain and bloody drainage. Otitis externa is an infection of the outer ear canal, often caused by bacterial or fungal infections, and is common in adolescents, especially those who swim frequently.
- Other Likely Diagnoses
- Acute Otitis Media with Perforation: This condition involves a middle ear infection that has perforated the eardrum, leading to bloody drainage. It's a common condition in children and adolescents.
- Trauma to the Ear Canal: Direct trauma to the ear canal, such as inserting objects like cotton swabs, can cause pain and bloody drainage.
- Eczema or Allergic Reaction of the Ear Canal: Eczema or an allergic reaction in the ear canal can cause itching, pain, and sometimes bloody discharge due to scratching.
- Do Not Miss Diagnoses
- Malignancy (e.g., Rhabdomyosarcoma): Although rare, malignancies can present with ear pain and bloody drainage. It's crucial to consider this possibility to ensure timely diagnosis and treatment.
- Necrotizing Otitis Externa: A severe form of otitis externa that can spread to the skull base and is more common in immunocompromised patients. It requires prompt recognition and treatment.
- Middle Ear Cholesteatoma: A type of skin cyst in the middle ear that can cause destruction of the surrounding bone and tissue, leading to complications like facial paralysis or hearing loss if not addressed.
- Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation and destruction of cartilaginous structures, including those in the ear, leading to pain and potential bloody drainage.
- Granulomatosis with Polyangiitis (formerly known as Wegener's Granulomatosis): A rare autoimmune disorder that can affect various parts of the body, including the ears, and cause symptoms like ear pain and bloody discharge.
- Otosclerosis: A condition that affects the middle ear, causing hearing loss, and can sometimes present with ear pain. Bloody drainage is less common but can occur in advanced cases.