Differential Diagnosis

The patient presents with ear pain that is constant, not just with chewing, and has recently experienced a sore throat and swollen lymph nodes. Based on the provided information, the following differential diagnoses are considered:

• Single most likely diagnosis
  • Otitis Media: The constant ear pain, recent sore throat, and swollen lymph nodes suggest an infection of the middle ear, which is a common complication of upper respiratory infections.
• Other Likely diagnoses
  • Otitis Externa: Also known as swimmer's ear, this condition is possible given the patient's surfing activities and could cause constant ear pain.
  • Eustachian Tube Dysfunction: This condition can cause ear pain and is often associated with upper respiratory infections, which the patient has recently experienced.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Mastoiditis: A serious infection of the mastoid bone, which can occur as a complication of otitis media. Although less likely, it is crucial to consider due to its potential severity.
  • Lymphoma: Although rare, lymphoma could cause swollen lymph nodes and should be considered to ensure timely diagnosis and treatment if present.
• Rare diagnoses
  • Ramsay Hunt Syndrome: A rare condition caused by the varicella-zoster virus, which could result in ear pain and other symptoms like facial weakness, although the patient does not mention these specific symptoms.
  • Temporal Bone Fracture: Given the patient's history of falls while surfing, a fracture could be considered, although the absence of a direct impact or blow to the ear makes this less likely.