Differential Diagnosis for Red Face, Swollen Lymph Nodes, and Ear Pain

Single Most Likely Diagnosis

• Parotitis: This condition, often caused by viral infections like mumps, leads to inflammation of the parotid gland, which is located near the ear. Symptoms include a red, swollen face, particularly in the area of the parotid gland, swollen lymph nodes, and ear pain due to the proximity of the gland to the ear.

Other Likely Diagnoses

• Cellulitis: A bacterial skin infection that can cause redness, swelling, and pain in the affected area, including the face. Swollen lymph nodes can occur as the body responds to the infection, and if the infection is near the ear, it could cause ear pain.
• Lymphadenitis: Inflammation of the lymph nodes, which can be caused by infection, leading to swollen lymph nodes, and if the infection spreads or is located near the ear, it could cause ear pain and facial redness.
• Dental Abscess: An infection of the tooth or gums can cause pain, swelling, and redness in the face, especially if the abscess is located in an upper tooth. The infection can also cause swollen lymph nodes and, if severe, could lead to ear pain due to referred pain.

Do Not Miss Diagnoses

• Ludwig's Angina: A severe infection of the tissues in the neck, which can cause swelling, redness, and pain in the face and neck. It's a medical emergency because it can lead to airway obstruction. Although less common, it's critical not to miss this diagnosis due to its potential severity.
• Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition where a blood clot forms in the cavernous sinus, which can be a complication of facial infections. Symptoms can include facial pain, swelling, and redness, along with swollen lymph nodes and potentially ear pain if the condition affects nearby structures.

Rare Diagnoses

• Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the lymph nodes and the parotid gland, leading to symptoms like swollen lymph nodes, facial swelling, and potentially ear pain if the ears are involved.
• Tuberculosis: Although rare in some parts of the world, TB can cause lymphadenitis and other systemic symptoms, including facial swelling and ear pain if the infection is located in the head or neck area.
• Actinomycosis: A rare bacterial infection that can cause abscesses and inflammation in the face and neck, leading to symptoms like redness, swelling, swollen lymph nodes, and potentially ear pain.