Advanced Health Assessment Practice Exam

What is the likely diagnosis for a patient with ear pain, drainage, and pain upon manipulation of the tragus, particularly with a swimming history?

1. Otitis media

2. Otitis externa

3. Tympanic membrane perforation

4. Cholesteatoma

The correct answer is: Otitis externa

The symptoms described — ear pain, drainage, and pain upon manipulation of the tragus — strongly suggest a diagnosis of otitis externa. This condition, often known as swimmer's ear, is characterized by inflammation of the external auditory canal, frequently due to water exposure leading to moisture accumulation, which can facilitate bacterial or fungal growth. In this case, the patient's history of swimming further supports this diagnosis, as exposure to water can predispose individuals to infections of the ear canal. The pain with tragal manipulation is particularly indicative of otitis externa, as this action puts pressure on the inflamed tissues of the ear canal, amplifying discomfort. Additionally, ear drainage is a common symptom associated with otitis externa, which may present as a purulent discharge if a bacterial infection is present. Understanding this context helps clarify how the symptoms align perfectly with otitis externa, making it the most likely diagnosis for this patient. Other conditions like otitis media, tympanic membrane perforation, and cholesteatoma have different presentations and mechanisms, which differentiates them from the situation at hand.