{
  "schema_version": 1,
  "kind": "condition",
  "id": "fear-of-ear-disease",
  "name": "Concern or fear of ear disease",
  "category": "chronic",
  "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class HS90 - condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway, no medicine given in primary care",
  "review_status": "reviewed",
  "verified_against": "No dose - referral pathway, no medicine given in primary care",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 712,
      "generic": "No drug therapy in primary care (Recognition & Referral)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "A patient presenting with anxiety regarding ear disease requires a thorough otoscopic examination and basic hearing assessment (whisper voice test, Weber and Rinne tuning fork tests) to rule out physical pathology such as otitis media, tympanic perforation, cerumen impaction, or cholesteatoma. Reassure the patient once organic disease is excluded and explain how stress or somatization can amplify benign auditory sensations or mild subjective tinnitus. Refer to ENT if objective hearing loss or structural lesions are identified, or to psychological services if health anxiety remains debilitating.",
      "adult_duration": "Refer",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "A patient presenting with anxiety regarding ear disease requires a thorough otoscopic examination and basic hearing assessment (whisper voice test, Weber and Rinne tuning fork tests) to rule out physical pathology such as otitis media, tympanic perforation, cerumen impaction, or cholesteatoma. Reassure the patient once organic disease is excluded and explain how stress or somatization can amplify benign auditory sensations or mild subjective tinnitus. Refer to ENT if objective hearing loss or structural lesions are identified, or to psychological services if health anxiety remains debilitating.",
      "cautions": [
        "RED FLAG - Associated cranial nerve palsies, facial asymmetry, or true rotational vertigo with nystagmus: assess urgently and refer.",
        "RED FLAG - Post-auricular swelling, erythema, and tenderness indicating acute mastoiditis: assess urgently and refer.",
        "Make sure a genuine symptom (pain, discharge, hearing loss) is not being dismissed as anxiety.",
        "No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "fear-of-ear-disease"
    }
  ]
}