differential diagnoses of complaints of ear pain

Discussion Question 1

Children and adults often present with complaints of ear pain. Your differential diagnoses should include otitis media and otitis externa, in addition to other possibilities such as foreign body obstruction and cerumen impactions. Give a brief overview of otitis media and otitis externa, including signs and symptoms of the most common causative agents for both. In addition, discuss the physical exam findings that you might see with the conditions when visualizing various parts of the ear such as ear canal or the tympanic membrane. How will your assessment of the ear differ in children versus adults? What would be essential health history questions to ask patients that present with ear pain and why? Support your answers with evidence-based guidelines references and articles no later than five years old, APA format.

Expert Solution Preview

Introduction:

Ear pain is a common presenting complaint in both children and adults, which can be caused by various conditions, including otitis media and otitis externa. As a medical professor, it is essential to have an in-depth understanding of these conditions to educate medical college students correctly. In this response, we will discuss the differential diagnoses, signs and symptoms, physical exam findings, assessment of the ear in children versus adults, and essential health history questions to ask patients with ear pain.

Answer:

Otitis media is an infection of the middle ear, commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Signs and symptoms include ear pain, fever, hearing loss, and discomfort while lying down. On physical examination, the ear canal can be red, and there is bulging of the tympanic membrane with decreased mobility and a cloudy appearance.

Otitis externa is an infection of the outer ear, commonly caused by Pseudomonas aeruginosa or Staphylococcus aureus. Signs and symptoms include ear pain, itching, and discharge. On physical examination, there is inflammation and narrowing of the ear canal, tenderness to touch, and discharge.

The assessment of the ear in children versus adults differs in the physical examination. Children require an appropriate technique to facilitate visualization of the ear canal and tympanic membrane. In contrast, adults can tolerate a direct approach. Additionally, health history questions that are essential to ask patients with ear pain include the presence of fever, hearing loss, recent upper respiratory tract infections, presence of eczema or other dermatologic conditions, swimming, and the use of hearing aids or earplugs.

In conclusion, ear pain is a common presenting complaint, and it is vital to have a differential diagnosis that includes otitis media and otitis externa. The assessment of the ear and health history questions should be tailored to the patient’s age, and evidence-based guidelines should be followed to ensure proper diagnosis and management.

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