Differential Diagnosis for 16 y/o with Hemoptysis and Earache
- Single most likely diagnosis
- Pneumonia: The presence of hemoptysis (spitting phlegm with blood) and earache could be indicative of a respiratory infection such as pneumonia, which can cause referred pain to the ear due to the shared nerve pathways.
- Other Likely diagnoses
- Bronchitis: Similar to pneumonia, bronchitis can cause hemoptysis, especially if it's chronic. The earache could be a separate issue or related to a postnasal drip.
- Sinusitis: Sinus infections can cause postnasal drip, leading to cough and potentially hemoptysis. The earache could be related to the sinusitis due to the close proximity of the sinuses to the ears.
- Tonsillitis: Although less likely to cause hemoptysis directly, severe tonsillitis could lead to bleeding, and the earache could be due to referred pain from the throat.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary Embolism: Although rare in a 16-year-old, a pulmonary embolism could cause sudden onset of hemoptysis and chest pain, which might be referred to the ear.
- Lung Cancer: Extremely rare in teenagers but could present with hemoptysis. The earache would be an unusual associated symptom but should not rule out this diagnosis if other risk factors or symptoms are present.
- Tuberculosis (TB): TB can cause hemoptysis and might be associated with ear pain if there's lymphadenopathy or other complications affecting the ear.
- Rare diagnoses
- Mitral Stenosis: A heart condition that can lead to hemoptysis due to pulmonary congestion. It's rare in teenagers without a history of rheumatic fever.
- Goodpasture Syndrome: An autoimmune disease causing glomerulonephritis and pulmonary hemorrhage, presenting with hemoptysis. It's rare and would typically have other systemic symptoms.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A vasculitis that can affect the lungs and kidneys, causing hemoptysis among other symptoms. It's rare and usually presents with a combination of respiratory and renal symptoms.