Differential Diagnosis for a 38-year-old with Ear Ache
Single Most Likely Diagnosis
- Acute Otitis Media: This is the most common cause of earache in adults, often resulting from a bacterial or viral infection of the middle ear. The symptoms typically include ear pain, fever, and sometimes hearing loss or a sensation of fullness in the ear.
Other Likely Diagnoses
- Otitis Externa (Swimmer's Ear): An infection of the outer ear canal, often caused by bacterial or fungal pathogens. It's common in individuals who swim frequently or have excessive moisture in the ear canal.
- Eustachian Tube Dysfunction: This condition occurs when the tube that connects the middle ear to the back of the throat doesn't open and close properly, leading to a feeling of fullness or pressure in the ear.
- Earwax Impaction: A buildup of earwax can cause discomfort, hearing loss, and a sensation of fullness in the ear, which might be perceived as an earache.
Do Not Miss Diagnoses
- Mastoiditis: A serious infection of the mastoid bone, located behind the ear. It can arise as a complication of untreated or inadequately treated otitis media and requires prompt medical attention.
- Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone, which can lead to severe complications if not treated promptly.
- Ramsay Hunt Syndrome (Herpes Zoster Oticus): A condition caused by the varicella-zoster virus, leading to facial paralysis, ear pain, and sometimes hearing loss or vertigo.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation and damage to cartilaginous structures, including those in the ear.
- Temporal Bone Tumors: Although rare, tumors of the temporal bone can cause ear pain among other symptoms, depending on their location and the structures they affect.
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which can sometimes cause ear pain, although it's more commonly associated with facial pain.