Differential Diagnosis for Fatigue following URI, Left Earache, and Off Balance
- Single most likely diagnosis
- Viral labyrinthitis or vestibular neuritis: This condition is a common cause of vertigo and imbalance following a viral upper respiratory infection (URI). The symptoms of fatigue, earache, and feeling off balance are consistent with this diagnosis, as the viral infection can affect the inner ear and cause vestibular symptoms.
- Other Likely diagnoses
- Acute otitis media: This is an infection of the middle ear that can cause earache, fatigue, and imbalance if the infection affects the inner ear or causes a significant amount of pain and discomfort.
- Benign paroxysmal positional vertigo (BPPV): Although BPPV is more commonly associated with brief episodes of vertigo triggered by specific head movements, it could be considered in the differential diagnosis, especially if the patient experiences vertigo in addition to feeling off balance.
- Post-viral fatigue syndrome: Some patients may experience prolonged fatigue following a viral infection, which could be accompanied by other symptoms such as earache and imbalance if the viral infection has affected the inner ear.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis: Although less likely, meningitis is a serious and potentially life-threatening condition that can present with non-specific symptoms such as fatigue, earache, and imbalance, especially in the early stages.
- Stroke or cerebellar infarct: A stroke affecting the cerebellum or brainstem can cause sudden onset of vertigo, imbalance, and other neurological symptoms. It is crucial to consider this diagnosis, especially in older patients or those with risk factors for stroke.
- Rare diagnoses
- Autoimmune inner ear disease: This is a rare condition characterized by recurrent episodes of vertigo, hearing loss, and ear fullness, which could be considered if the patient's symptoms persist or worsen over time.
- Vestibular schwannoma (acoustic neuroma): A rare benign tumor affecting the vestibulocochlear nerve, which could cause progressive imbalance, vertigo, and hearing loss, typically on one side.