Publications
Partners
Mr T, a 32-year-old mechanical engineer, has had significant pain and discomfort in his left ear over the past week. At first he thought it might be due to a bout of flu he suffered a week before, but when he noticed a discharge from his ear, he decided to go to the doctor.
The following is a summary of the doctor's notes:
History:
One week history of progressively worsening pain in left ear. Associated with discharge.
Swam in a heated pool two weeks ago.
Pain not relieved by simple pain medication.
Reports decrease in hearing ability.
Had an upper respiratory tract infection about a week ago which cleared.
No other medical or surgical history.
Smoker, but does not use alcohol.
On examination:
Generally well. Temperature: 36,9
Large lymph node just below left ear.
All systems found to be normal om examination.
Right ear: normal examination
Left ear: red, irritated external ear. Some yellow fluid draining from ear canal. Patient reports increase in pain with touch to the pinna and tragus.
Otoscopy: very swollen, inflamed ear canal, so much so that the otoscope speculum can not be passed into the ear canal. Unable to see the eardrum.
In the light of the information above, what is the most likely cause of Mr T's condition?
NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.
Previously on What's Your Diagnosis?
What's your diagnosis? - Case 1: vomiting and weight loss
What's your diagnosis? - Case 2: eye pain
What's your diagnosis? - Case 3: strange behaviour and a bullet in the back
What's your diagnosis? - Case 4: seeing odd things
What's your diagnosis? - Case 5: mysterious lungs
What's your diagnosis? - Case 6: runner with seizures
What's your diagnosis? - Case 7: swollen knee
What's your diagnosis? - Case 8: bloody semen
What's your diagnosis? - Case 9: confusing neurological signs
What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms
What's your diagnosis? - Case 11: bruising with no apparent reason
What's your diagnosis? - Case 12: severe tummy pain
What's your diagnosis? - Case 13: severe sore throat
What's your diagnosis? - Case 14: abdominal pain and swelling
What's your diagnosis? - Case 15: the world is spinning
What's your diagnosis? - Case 16: numbness in forearm
What's your diagnosis? - Case 17: burning urine
What's your diagnosis? - Case 18: boy with persistent fever
What's your diagnosis? – Case 19: lady who can't lose weight
What's your diagnosis? – Case 20: chest pain next to breastbone
What's your diagnosis? – Case 21: burning sensation in vagina
What's your diagnosis? – Case 22: vomiting and headaches
What's your diagnosis? – Case 23: frequent urination
What's your diagnosis? – Case 24: painful and swollen leg
What's your diagnosis? – Case 25: swollen knee and fever
