Differential Diagnosis for Severe Ear Pain
- Single most likely diagnosis
- Otitis externa: This condition, also known as swimmer's ear, is an inflammation of the outer ear and ear canal. It can cause severe ear pain, especially when the outer ear is touched or pulled, which matches the description of pain like being "jabbed." The pain can be sharp and stabbing, consistent with the severity described.
- Other Likely diagnoses
- Otitis media: This is an infection of the middle ear and can cause significant pain, especially in children but also in adults. The pain can be severe and is often accompanied by other symptoms like fever and hearing loss.
- Eustachian tube dysfunction: This condition affects the tube that connects the middle ear to the back of the nose and throat. Dysfunction can lead to severe ear pain, especially during or after air travel, or with allergies and colds.
- Temporomandibular joint (TMJ) disorder: While primarily affecting the jaw, TMJ disorders can radiate pain to the ear, which might be perceived as severe ear pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant otitis externa: A severe infection of the outer ear that can spread to the skull and brain, particularly in diabetic or immunocompromised patients. It requires prompt and aggressive treatment.
- Mastoiditis: An infection of the mastoid bone in the skull, located behind the ear. It can be a complication of untreated or inadequately treated otitis media and can lead to serious complications, including brain abscesses.
- Petrous apicitis: A rare but serious infection of the petrous part of the temporal bone, which can lead to severe complications if not promptly treated.
- Rare diagnoses
- Ramsay Hunt syndrome: Caused by the varicella-zoster virus, this condition can lead to severe ear pain, along with facial paralysis and vesicles in the ear.
- Glossopharyngeal neuralgia: A rare condition characterized by sharp, stabbing pain in the back of the throat and the ear, often triggered by swallowing.
- Otosclerosis: A form of bone growth in the middle ear that can cause hearing loss and may lead to ear pain, though this is less common.