Case and Discussion

Caseand Discussion

Individualswith ear pain often experience discomfort in the inner or the outerear. Most problems associated with the ear are often caused byinfections. However, there are other conditions that may lead to earpain and discomfort, especially in adults. As such, pinpointing thesymptoms and the conditions surrounding the ear pain prove vital inthe process of providing the correct diagnosis. In the case provide,the 21-year old woman has a 2-day history of pain in her right earwhich began shortly after taking scuba diving lesson. She describesher pain as a pressure, notes crackling in the ear and periodicallyfeels dizzy. As such, this essay describe other associated symptoms Ishould ask about, how the time course helps to distinguish among thedifferent causes of the ear pain, how the patient’s age narrows thediagnostic possibilities, other diagnostic tests that would help withthe diagnosis and provides a differential diagnosis flow sheet forthe patient and includes the diagnostics as well as thepharmacological management and rationale related to thedifferentials.

Associatedsymptoms to ask about

Fromthe given case, there are several other symptoms that if asked about,would help in providing the correct diagnosis. These includeexperiences of popping or crackling sounds in the ear and reducedhearing. I would also ask the patient if she has experienced frequentfeelings of nausea or vomiting and any form of drainage from the earwhich may either be a bloody or pus-filled drainage.

Howthe time course help distinguish among the different causes of earpain

Thepatient’s 2-day time course during which she has experienced thesymptoms play a vital role in differentiating among the possiblecauses of the pain. This is given that some of the symptoms oftendisappear once the scuba diver returns the surface as the body triesto adjust back to its optimum functioning. In other instances, theresulting symptoms may occur a few hours after the dive and becomepersistent for days. This may provide a basis for which a diagnosiscan be provided.

Howthe patient age helps in narrowing the diagnostic possibilities

Thepatient’s age is a vital characteristic is narrowing down thediagnostic possibilities of ear pains. This is because the agecharacteristic aids in identifying the susceptibility and prevalenceof the diagnosis that is associated with the various age groups. Forinstance, most ear pain in infants and kids are mostly caused byinfections rather that other situational causes, such as scubadiving, as in the case of adults.

Otherdiagnostic tests to be included

Anothertest that may be conducted to provide the appropriate diagnosisincludes an examination of the ear with the use of an otoscope. Suchan exam would reveal any form of swelling, redness or perforation ofthe eardrum.

Differentialdiagnosis flow sheet

Ear pain


Signs and Symptoms

– Dizziness

– Sensation of stiffness of fullness in the ear (MedlinePlus, 2016)

– Loss of hearing

– Pain in one ear or both

– Feeling of pressure in the ear

Pharmacological management

  • Medication

– Prescribed antibiotics or steroids in cases of inflammations and infections

  • Painkillers (Ibuprofen, Acetaminophen) (WebMD, 2016)

Rationale for differential

– Due to patient’s age


Signs and Symptoms

– Severe and throbbing ear pain

– Nausea/Vomiting

– Drainage of fluid from the ear

– Hearing loss

– Feeling of fullness in the ear

– Vertigo

– Lack of balance

(Kivi &amp Yu, 2016)

Pharmacological management

  • Medication

– Antibiotics

– Analgesics

Rationale for differential

– Due to patient symptoms and time course

Common signs and symptoms

– Hearing loss

– Pain in the ear

– Dizziness


Inlight of the above, it is evident that the diagnosis of ear painsrequires much attention in order to provide the correct diagnosis. Assuch, it is important to ask about other associated symptoms that thepatient might be experiencing such as crackling sounds and feelingsof nausea. The time course would also help in distinguishing thecause of the pain with regards to the symptoms, while the age may bevital in determining diagnostic possibilities in terms of prevalenceand susceptibility. Moreover, more ear tests using the otoscope maybe carried out to provide the appropriate diagnostic. Coupled with adifferential analysis, the correct diagnosis of the ear pain maytherefore be provided.


Kivi,R. &amp Yu, W. (2016). Acute Otitis Media. Healthline. Retrieved 1November 2016, from

MedlinePlus.(2016). Ear barotrauma: MedlinePlus Medical Retrieved 1 November 2016, from

WebMD.(2016). Ear Pain, Scuba Diving Treatment. WebMD. Retrieved 1 November2016, from