Differential Diagnosis for 16-year-old Male with Ear Symptoms
- Single most likely diagnosis:
- Otitis Externa (Swimmer's Ear): This is the most likely diagnosis given the patient's history of swimming in Florida, getting water in his ear, and subsequent development of ear pain, ringing, fullness, and decreased hearing. The use of over-the-counter eardrops without improvement also supports this diagnosis, as otitis externa often requires prescription-strength treatments.
- Other Likely diagnoses:
- Middle Ear Effusion: The patient's symptoms of fullness, ringing, and decreased hearing could be indicative of a middle ear effusion, which can occur after an upper respiratory infection or as a complication of otitis externa.
- Eustachian Tube Dysfunction: The patient's symptoms of fullness and decreased hearing could be related to Eustachian tube dysfunction, which can occur after a change in air pressure or as a result of an upper respiratory infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Malignant Otitis Externa: Although rare, malignant otitis externa is a serious and potentially life-threatening condition that can occur in immunocompromised individuals. It is essential to consider this diagnosis, especially if the patient has a history of immunosuppression or if the symptoms worsen despite treatment.
- Acoustic Neuroma: A rare tumor that can cause ringing, fullness, and decreased hearing. Although unlikely, it is essential to consider this diagnosis to avoid missing a potentially treatable condition.
- Rare diagnoses:
- Labyrinthitis: An inner ear infection that can cause vertigo, ringing, and decreased hearing. Although rare, it is essential to consider this diagnosis, especially if the patient reports vertigo or balance problems.
- Cholesteatoma: A rare skin growth in the middle ear that can cause decreased hearing, ringing, and fullness. Although unlikely, it is essential to consider this diagnosis, especially if the patient has a history of recurrent ear infections or if the symptoms worsen despite treatment.