Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What can cause sudden ear pain?
How do you treat an ear infection?
Can nasal congestion cause ear pain?
What can I do to relieve nasal congestion?
Is a headache related to ear pain?
Should I avoid swimming if I have ear pain?
Are seasonal allergies causing my ear pain?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hi there! So you're here today because of some right ear pain, is that correct?
Patient
Yes, that's right.
Cody, the AI Doctor
It's nice to meet you! My goal is to provide you with an accurate assessment and plan. Let's delve into your ear pain a bit more. When did the pain first start?
Patient
It started about five days ago, very suddenly.
Cody, the AI Doctor
On a scale of 1 to 10, with 1 being no pain and 10 being the most severe pain you've ever felt, how would you rate the severity of your ear pain?
Patient
I'd say it's a 7.
Cody, the AI Doctor
That sounds quite uncomfortable. Have you experienced anything similar before, or is this the first time?
Patient
This is the first time I've had ear pain like this.
Cody, the AI Doctor
Got it. Have you noticed any other symptoms like hearing loss, ear discharge, dizziness, or ringing in the ears?
Patient
I haven't noticed any discharge or ringing, but my hearing is a bit muffled on that side.
Cody, the AI Doctor
Thank you for sharing that. Do you have any history of chronic illnesses like asthma, and are you currently taking any medications?
Patient
No chronic illnesses, and I'm not on any medications.
Cody, the AI Doctor
Understood. Have you been dealing with any other symptoms lately, like a runny nose, nasal congestion, or a cough?
Patient
Yes, actually. I've had a really stuffy nose, runny nose, and a cough for the past two weeks. No fever though.
Cody, the AI Doctor
Got it. Any headaches or facial pain?
Patient
I've had a pretty bad headache, mostly in the front of my head.
Cody, the AI Doctor
Do you have any seasonal allergies that might be contributing to these symptoms?
Patient
Yes, I do have seasonal allergies.
Cody, the AI Doctor
It's good to know. Are you a smoker or have you been exposed to any environmental irritants recently?
Patient
No, I don't smoke and haven't been around any irritants.
Cody, the AI Doctor
Thanks for the information. One last question: I see you're an active person who runs and swims. Have you noticed any issues while swimming recently?
Patient
I haven't been swimming since my ear started to hurt.
Cody, the AI Doctor
Thank you for all the information.
Cody's AI Summary
- You are a 26-year-old woman experiencing very severe right ear pain (rated 7 out of 10) that started suddenly five days ago.
- You have no known chronic illnesses or asthma and are not on any medications.
- You have seasonal allergies and have been dealing with significant nasal congestion, runny nose, and a cough for two weeks without a fever.
- You've also had a frontal headache. Your hearing in the affected ear is slightly muffled, but there's no discharge, dizziness, or ringing.
- You do not smoke and haven't been exposed to any environmental irritants. You are active in running and swimming but have avoided swimming since the onset of pain.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Otitis Media( 50 % probability)
Likely due to recent upper respiratory symptoms—nasal congestion and runny nose leading to fluid build-up and infection in the middle ear.
2. Eustachian Tube Dysfunction(35 % probability)
Nasal congestion and runny nose might be contributing to this condition, where the tube connecting the middle ear to the back of the nose becomes blocked or doesn't function properly.
3. DX 3(15 % probability)
Even though the patient hasn't been swimming recently, it’s worth considering, particularly due to the severe and sudden ear pain.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
The patient's presentation of severe right ear pain, muffled hearing, and upper respiratory symptoms strongly suggests a middle ear pathology. The absence of fever and ear discharge makes otitis media and eustachian tube dysfunction more likely than otitis externa.
1. Otitis Media (Middle Ear Infection)(60% probability)
The patient’s symptoms of nasal congestion, runny nose, and recent respiratory infection are common antecedents of otitis media due to eustachian tube blockage and fluid accumulation.
2. Eustachian Tube Dysfunction(30% probability)
Given the significant nasal congestion and runny nose, the eustachian tube dysfunction could easily result from swelling and blockage. This condition commonly presents without fever or discharge.
3. Otitis Externa (Swimmer's Ear)(10% probability)
Despite the sudden onset of ear pain, the lack of swimming activity and absence of ear discharge lower the likelihood of this diagnosis. Also to consider is
Next Steps for Evaluation
The first step is a a physical examination, including otoscopy, to inspect the ear canal and tympanic membrane. This would help discussion between the three primary proposed diagnoses.
Potential Treatment Modalities
Otitis Media: Antibiotics, decongestants, and pain management.
Eustachian Tube Dysfunction: Decongestants, antihistamines, and nasal corticosteroid sprays.
Sinusitis: Antibiotics (if bacterial), nasal decongestants, saline irrigation, and antihistamines.
Conclusion
The most probable diagnosis is otitis media, given the patient's upper respiratory symptoms and ear pain. Eustachian tube dysfunction is also a significant possibility. The patient should seek a physical examination by a healthcare provider for an accurate diagnosis and appropriate treatment.
Resource Center
Testimonials
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TrustPilot Review
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TrustPilot Review
Easily confirmed what I suspected. Very thorough, definitely the best thing you can get without speaking to a human. A nurse would ask the exact same questions and give you the exact same answers.
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