Differential Diagnosis for 69 yo Female with Bilateral Ear Pressure and Eye Swelling

Single Most Likely Diagnosis

• Allergic Reaction: This is a common condition that can cause bilateral ear pressure and eye swelling due to increased histamine release, leading to vasodilation and increased permeability of blood vessels. The symptoms can be triggered by various allergens such as pollen, dust mites, or certain foods.

Other Likely Diagnoses

• Sinusitis: Inflammation of the sinuses can cause pressure in the ears and face, including the eyes, due to the close anatomical relationship between the sinuses and these structures. Bacterial or viral infections are common causes.
• Temporal Arteritis: This condition, also known as giant cell arteritis, can cause swelling of the eyes and face, including ear pressure, due to inflammation of the blood vessels. It's more common in older adults.
• Dental Infection: An infection in the teeth or gums can cause referred pain and pressure in the ears and face, including swelling around the eyes, due to the shared nerve pathways.

Do Not Miss Diagnoses

• Angioedema: A severe, potentially life-threatening allergic reaction that can cause rapid swelling of the face, lips, tongue, and throat, which can lead to airway obstruction. It requires immediate medical attention.
• Cavernous Sinus Thrombosis: A rare but serious condition where a blood clot forms in the cavernous sinus, which can cause eye swelling, facial pain, and potentially life-threatening complications if not treated promptly.
• Orbital Cellulitis: A bacterial infection of the tissues surrounding the eye, which can cause swelling, redness, and pain. It can lead to serious complications, including vision loss, if not treated aggressively.

Rare Diagnoses

• Sarcoidosis: A condition characterized by the growth of granulomas (inflammatory cells) in various parts of the body, which can cause a wide range of symptoms, including eye and facial swelling, and ear pressure.
• Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that causes inflammation of the blood vessels, which can lead to symptoms such as eye and facial swelling, and ear pressure, among others.
• Relapsing Polychondritis: A rare disease characterized by recurring episodes of cartilage inflammation, which can affect the ears, nose, eyes, and joints, leading to a variety of symptoms including ear pressure and eye swelling.