Differential Diagnosis for Bilateral Ear Pain
- Single most likely diagnosis
- Middle Ear Barotrauma: This condition is likely due to the patient blowing her nose and hearing a popping sound, which suggests a sudden change in ear pressure. The sharp and intermittent pain is consistent with this diagnosis.
- Other Likely diagnoses
- Eustachian Tube Dysfunction: This condition can cause ear pain, especially after activities that involve changes in pressure, such as blowing the nose. It is a common issue in children and can be related to the patient's symptoms.
- Earwax Impaction: Although less likely given the acute onset, earwax impaction can cause ear pain and is a common issue in children.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Temporal Bone Fracture: Although rare, a temporal bone fracture can cause ear pain and is a serious condition that requires prompt attention. The history of a popping sound after blowing the nose could be a red flag for this condition.
- Meningitis: In rare cases, ear pain can be a symptom of meningitis, especially if it is accompanied by other symptoms such as fever, headache, and stiff neck.
- Rare diagnoses
- Patulous Eustachian Tube: This is a rare condition where the Eustachian tube remains open, causing autophony and ear fullness. It is less likely given the acute onset of symptoms but could be considered if other diagnoses are ruled out.
- Otosclerosis: This is a rare condition that affects the middle ear and can cause ear pain, but it is less likely in a 7-year-old child and typically has a more gradual onset.