Differential Diagnosis for 18-year-old Male with Left Ear Pain
- Single most likely diagnosis
- Otitis media: This is the most likely diagnosis given the patient's recent history of cold-like symptoms, which are a common precursor to otitis media. The ear pain is consistent with this diagnosis, and the absence of fever or ear drainage does not rule it out, especially if the infection is viral or in its early stages.
- Other Likely diagnoses
- Otitis externa (swimmer's ear): This condition is possible, especially if the patient has been swimming or engaging in activities that expose the ear canal to moisture. However, the recent cold-like symptoms make otitis media slightly more likely.
- Eustachian tube dysfunction: This condition can cause ear pain and is often associated with recent upper respiratory infections, which could explain the patient's symptoms.
- Earwax impaction: This is a common cause of ear pain and could be considered, especially if the patient has been using Q-tips or has a history of earwax issues.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Mastoiditis: Although less likely, mastoiditis is a serious complication of otitis media that requires prompt treatment. It can present with ear pain, fever, and other symptoms, but the absence of fever in this case does not rule it out entirely.
- Petrous apicitis: This is a rare but serious complication of otitis media that involves the petrous part of the temporal bone. It can present with ear pain and other neurological symptoms, making it a "do not miss" diagnosis.
- Temporal bone fracture or other trauma: Although the patient does not report any trauma, it is essential to consider this possibility, especially if there are any inconsistencies in the patient's history or if the physical examination reveals any signs of trauma.
- Rare diagnoses
- Ramsay Hunt syndrome (herpes zoster oticus): This condition is caused by the reactivation of varicella-zoster virus in the geniculate ganglion and can present with ear pain, facial weakness, and other symptoms.
- Otosclerosis: This is a rare condition that affects the middle ear and can cause ear pain, hearing loss, and other symptoms. However, it is less likely in this scenario given the patient's recent cold-like symptoms.
- Relapsing polychondritis: This is a rare autoimmune disorder that can affect the cartilage of the ear and other parts of the body, causing ear pain, redness, and other symptoms.