Misdiagnosis of Middle Ear Infection
Undiagnosed Ear Infection: A middle ear infection is often diagnosed late, because the person typically already has a respiratory infection (e.g. common cold, flu), or a throat infection. The distinctive symptoms are therefore often ear pain, or a fever that seems to last too long.
Young Children and Babies: A middle ear infection in a young child or infant may be overlooked because the child simply cannot properly communicate that they have ear pain. Fever is common, but may be overlooked as the child has already had a fever from the previous viral infection. Ear pulling is a good sign of ear pain in children. Excessive crying or persistent screaming in a baby or infant also may strongly indicate ear pain. Vomiting or diarrhea are also possible symptoms of ear infection in young children. Where a fever from a common cold seems to have lasted too long, it could indicate an ear infection (or alternatively, it could also be another different complication of common cold, such as pneumonia).
Differential Diagnosis: There are a number of other conditions that need to be considered:
- Inner ear infection (labyrynthitis)
- Outer ear infection (otitis externa)
- Glue ear
- Tonsillitis. Ear pulling can be a symptom of tonsillitis in young children. And tonsillitis can also be related to ear infections.
- Adenoiditis. As with tonsillitis, this condition can block the Eustachian tube.
- Ear tugging (other causes).
- Ear pain (various causes). Other causes of ear pain are possible.
Chronic Hearing Loss: A middle ear infection, recurring or chronic, and the resulting problems with the Eustachian tube can certainly cause hearing loss. However, with a diagnosis of chronic otitis media as the cause of hearing loss, there are other possible cause that need to be on the differential diagnosis, especially where the hearing loss appears progressive and chronic.
- Glue ear
- Meniere’s Disease
- Noise-induced hearing loss
- Hearing loss (all causes). There are a variety of possible causes that need to be examined thoroughly.
Undiagnosed Complications: Some of the complications of middle ear infection can be serious and may be problematic for diagnosis:
- Ruptured Ear Drum
- Labyrynthitis. An inner ear infection can occur as a complication of middle ear infection.
- Mastoiditis. An infection spread to the mastoid bone.
- Meningitis. An infection spread to the meninges (spinal cord and brain membranes).
- Brain Abscess
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