A 35-year-old man presented to the ear, nose, and throat outpatient department with a 1-week history of painful swelling of the right ear. He was having recurrent episodes of similar illness in both ears, for the past 5 years, for which he was treated multiple times with antibiotics and analgesics. These episodes used to subside themselves or with the above medications.
He also complaints of a 3-months history of weight loss, fatigue, and generalized aches.
- Right pinna was tender, edematous and erythematous. Ear lobule was spared. The tympanic membrane was appearing normal.
- No significant positive finding in the left ear.
- Nose: Saddle-nose deformity present.
- Oral cavity: Normal
- Oropharynx: Normal
- Throat: Normal
- The costochondral joints were tender on palpation, and the right knee was swollen and tender.
- Routine lab investigation values were within normal limits, except for an elevated ESR of more than 120 mm per hour (reference range, 0 to 15).
- What is your provisional diagnosis?