Differential Diagnosis for Bilateral Ear Pain

• Single most likely diagnosis
  • Otitis media: This is a common condition that can cause bilateral ear pain, especially in children. It is often associated with upper respiratory infections and can be caused by bacterial or viral pathogens.
• Other Likely diagnoses
  • Otitis externa: Also known as swimmer's ear, this condition is an inflammation of the outer ear and ear canal. It can cause bilateral ear pain, especially if the patient has been swimming or exposed to water.
  • Eustachian tube dysfunction: This condition can cause ear pain and discomfort, especially during air travel or with changes in altitude.
  • Temporomandibular joint (TMJ) disorder: TMJ disorders can cause referred pain to the ears, and can be a common cause of bilateral ear pain.
• Do Not Miss diagnoses
  • Meningitis: Although rare, meningitis is a life-threatening condition that can cause ear pain, along with other symptoms such as fever, headache, and stiff neck.
  • Mastoiditis: This is a serious infection of the mastoid bone, which can cause ear pain, fever, and other symptoms.
  • Petrous apicitis: This is a rare but serious condition that can cause ear pain, along with other symptoms such as fever, headache, and cranial nerve palsies.
• Rare diagnoses
  • Relapsing polychondritis: This is a rare autoimmune disorder that can cause inflammation of the cartilage in the ears, leading to ear pain and other symptoms.
  • Granulomatosis with polyangiitis (GPA): This is a rare autoimmune disorder that can cause inflammation of the blood vessels, including those in the ears, leading to ear pain and other symptoms.
  • Ramsay Hunt syndrome: This is a rare condition caused by the varicella-zoster virus, which can cause ear pain, along with other symptoms such as facial weakness and vesicles in the ear.