Differential Diagnosis for Ethan's Condition
Given the symptoms of teething, crying, and a small lump at the bottom of one ear that causes pain when pressed, the following differential diagnoses can be considered:
- Single most likely diagnosis
- Ear infection (otitis media): This is a common condition in infants, especially during teething. The lump could be a swollen lymph node or a sign of infection in the ear canal. The pain upon pressing and the context of teething make this a plausible diagnosis.
- Other Likely diagnoses
- Infected earlobe or periauricular infection: This could be due to a bacterial infection of the skin around the ear, possibly related to teething toys or other objects coming into contact with the ear.
- Lymphadenitis: Inflammation of the lymph nodes, which could be due to a viral or bacterial infection, and is consistent with the lump causing pain when pressed.
- Mastoiditis: An infection of the mastoid bone, which is located behind the ear. It's a complication of otitis media but less likely given the description of a lump at the bottom of the ear.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis: Although less likely, any sign of infection or severe pain in an infant warrants consideration of meningitis, especially if accompanied by fever, lethargy, or other signs of severe illness.
- Petrous apicitis: A rare but serious infection of the petrous part of the temporal bone, which could present with ear pain and could be a complication of otitis media.
- Rare diagnoses
- Dermoid cyst: A congenital cyst that could present as a lump, though it would be less likely to cause pain with pressure unless infected.
- First branchial cleft anomaly: A congenital anomaly that could present with a lump or cyst near the ear, potentially becoming infected and causing pain.
Each of these diagnoses should be considered in the context of Ethan's overall health, behavior, and physical examination findings. A healthcare professional's evaluation is necessary to determine the cause of the lump and appropriate treatment.