Differential Diagnosis
- Single most likely diagnosis
- Otitis externa: This is the most likely diagnosis given the patient's symptoms of a swollen, blocked, and sore left ear, with the outer ear being oedematous and the tympanic membrane red. The patient's history of using earbuds for cleaning, which can cause trauma to the ear canal and increase the risk of infection, also supports this diagnosis.
- Other Likely diagnoses
- Acute otitis media: Although the patient does not have discharge, the blocked hearing and painful ear could be indicative of an inner ear infection. The patient's history of previous bilateral ear infections also makes this a possible diagnosis.
- Eustachian tube dysfunction: The patient's complaint of a blocked ear and hearing loss could be related to Eustachian tube dysfunction, which can be caused by a variety of factors, including allergies, colds, or sinus infections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant otitis externa: Although rare, this condition can be life-threatening, especially in patients with diabetes or immunocompromised individuals. The patient's history of diabetes and the presence of severe ear pain and swelling make this a diagnosis that should not be missed.
- Temporal bone osteomyelitis: This is a rare but serious condition that can cause severe ear pain, swelling, and hearing loss. The patient's history of previous ear infections and the presence of severe ear pain make this a diagnosis that should be considered.
- Rare diagnoses
- Relapsing polychondritis: This is a rare autoimmune disorder that can cause inflammation and damage to the cartilage in the ear, leading to symptoms such as ear pain, swelling, and hearing loss.
- Ear canal cholesteatoma: This is a rare condition where a skin cyst grows in the ear canal, causing symptoms such as ear pain, swelling, and hearing loss. The patient's history of using earbuds for cleaning, which can cause trauma to the ear canal, makes this a possible diagnosis.