Differential Diagnosis for Dizziness and Ringing in Ears
Single Most Likely Diagnosis
- Aspirin or other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Aspirin and other NSAIDs are well-known to cause tinnitus (ringing in the ears) and dizziness as side effects, especially at higher doses. The timing of 7 days after starting the drug fits with the onset of these side effects.
Other Likely Diagnoses
- Quinine: Used for treating malaria, quinine can cause tinnitus and dizziness. Although less common than NSAIDs, it's a plausible cause given the symptoms.
- Certain Antibiotics (e.g., Erythromycin, Gentamicin): Some antibiotics, especially those in the aminoglycoside class like gentamicin, can cause ototoxicity leading to tinnitus and dizziness.
- Loop Diuretics (e.g., Furosemide): These can cause ototoxicity, leading to symptoms like tinnitus and dizziness, especially at high doses or with rapid infusion.
Do Not Miss Diagnoses
- Ototoxic Antibiotics (e.g., Streptomycin, Kanamycin): While less commonly used, these antibiotics can cause severe and irreversible ototoxicity. Missing this diagnosis could lead to permanent hearing loss or balance issues.
- Cisplatin: A chemotherapy drug known for its ototoxic effects, including tinnitus and hearing loss. Given its potential for severe side effects, it's crucial not to miss this diagnosis.
Rare Diagnoses
- Vancomycin: An antibiotic that can rarely cause ototoxicity, leading to tinnitus and dizziness, especially when used in combination with other ototoxic drugs.
- Certain Antidepressants (e.g., Amitriptyline): Some older antidepressants can cause tinnitus and dizziness as rare side effects, though this is less common compared to other causes listed here.