Differential Diagnosis for Left Ear Pain
The patient presents with left ear pain, maxillary sinus pressure, and a history of cold-like symptoms. The following differential diagnosis is organized into categories:
- Single most likely diagnosis
- Otitis media with eustachian tube dysfunction: The patient's symptoms of ear pain, particularly with chewing and opening her mouth wide, suggest eustachian tube dysfunction. The recent history of cold-like symptoms and improving nasal congestion, rhinorrhea, and cough support this diagnosis, as otitis media often follows an upper respiratory infection.
- Other Likely diagnoses
- Acute sinusitis: The patient's complaint of maxillary sinus pressure and recent cold-like symptoms make acute sinusitis a possible diagnosis. The ear pain could be referred pain from the sinuses.
- Temporomandibular joint (TMJ) disorder: The patient's ear pain with chewing and opening her mouth wide could be related to a TMJ disorder, which is often associated with jaw pain and clicking.
- Eustachian tube dysfunction without otitis media: The patient's symptoms of ear pain with chewing and opening her mouth wide could be due to eustachian tube dysfunction alone, without an infection.
- 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. The patient's ear pain and recent history of cold-like symptoms make this a diagnosis that should not be missed.
- Petrous apicitis: This is a rare but serious complication of otitis media that can cause severe headaches, ear pain, and cranial nerve palsies. Although unlikely, it is essential to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Rare diagnoses
- Ramsay Hunt syndrome: This is a rare condition caused by varicella-zoster virus reactivation, leading to ear pain, facial weakness, and vesicles in the ear. Although unlikely, it is essential to consider this diagnosis in patients with ear pain and facial weakness.
- Middle ear tumors: Although rare, middle ear tumors can cause ear pain, hearing loss, and other symptoms. This diagnosis is unlikely but should be considered in patients with persistent or severe ear pain.