Differential Diagnosis for Ear Pain in Urgent Care
Single Most Likely Diagnosis
- Otitis Media: This is the most common cause of ear pain, especially in children, but also occurs in adults. It is an infection of the middle ear that can be caused by bacteria or viruses, often following an upper respiratory tract infection. Symptoms include ear pain, fever, and hearing loss.
Other Likely Diagnoses
- Otitis Externa: Also known as swimmer's ear, this is an infection of the outer ear canal. It can be caused by bacteria or fungi and is often associated with water exposure, trauma to the ear canal, or excessive ear cleaning. Symptoms include ear pain, itching, and discharge.
- Eustachian Tube Dysfunction: This condition occurs when the tube that connects the middle ear to the back of the throat (Eustachian tube) does not open and close properly, leading to a feeling of fullness or pressure in the ear and sometimes pain.
- Earwax Impaction: The accumulation of earwax can cause ear pain, hearing loss, and a feeling of fullness in the ear. It is a common issue that can often be managed with earwax removal.
Do Not Miss Diagnoses
- Mastoiditis: A serious infection of the mastoid bone in the skull, located behind the ear. It can be a complication of untreated or inadequately treated otitis media. Symptoms include severe ear pain, fever, and swelling behind the ear.
- Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone. It can cause severe ear pain, headache, and neurological symptoms.
- Ramsay Hunt Syndrome: Caused by the varicella-zoster virus, this condition leads to facial paralysis and a rash in the ear, along with ear pain and sometimes hearing loss.
- Temporal Arteritis: Although more commonly associated with headache, this condition can cause ear pain, especially in older adults. It is an inflammation of the blood vessels and can lead to serious complications if not treated promptly.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation and damage to cartilage in various parts of the body, including the ears, leading to ear pain and other symptoms.
- Cholesteatoma: A type of skin cyst located in the middle ear that can cause ear pain, hearing loss, and other complications if it grows and damages surrounding structures.
- Ear Cancer: Although extremely rare, cancer of the ear (either the outer ear, ear canal, or middle ear) can cause persistent ear pain, among other symptoms.