Virtual Patients - Otology - Otorrhea

A 25-year-old man is referred in by the GP for recurrent ear infections. The infections consist of periods of very mild otalgia, otorrhea and an acute reduction in hearing.  He has had over 15 such infections in the last 3 years and has received numerous courses of antibiotics. However, a few weeks after receiving the medication, the offensive smelling discharge reoccurs. 

On examination, the GP found it difficult to visualise either eardrum due to wax. Other ENT examination and systems review was unremarkable. 

 

Question

 

At this point write down a differential diagnosis list for the case above. After exhausting your list check it against our list below.