Differential Diagnosis for Vertigo and Unilateral Hearing Loss in a 20-year-old following URI
- Single most likely diagnosis:
- Labyrinthitis: This condition is an inner ear disorder characterized by inflammation of the part of the inner ear responsible for balance (labyrinth). It can be caused by a viral infection, such as the one causing the URI, leading to symptoms like vertigo and hearing loss. The age and recent URI make this a plausible diagnosis.
- Other Likely diagnoses:
- Vestibular Neuritis: Similar to labyrinthitis but specifically involves the vestibular nerve, which is responsible for balance. It can also be triggered by a viral infection and presents with vertigo.
- Middle Ear Effusion: Fluid buildup in the middle ear can cause hearing loss and, less commonly, vertigo if the fluid affects the inner ear structures. This could be a complication of the URI.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Stroke or Cerebral Vasculitis: Although rare in young adults, a stroke or cerebral vasculitis could present with sudden onset of vertigo and hearing loss. It's crucial to rule out these conditions due to their severe implications.
- Multiple Sclerosis: An initial episode of vertigo and unilateral hearing loss could be a presenting symptom of multiple sclerosis, especially if accompanied by other neurological symptoms.
- Rare diagnoses:
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause hearing loss and balance problems. It's rare, especially in young adults, but should be considered if symptoms persist or worsen.
- Meniere's Disease: A disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. It's less common in young adults but could be a consideration if other diagnoses are ruled out.