What is the differential diagnosis (DDX) for a 9-year-old patient presenting with low-grade fever, sore throat, and cough?

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Differential Diagnosis for a 9-year-old with Low-grade Fever, Sore Throat, and Cough

  • Single most likely diagnosis:
    • Viral pharyngitis (e.g., adenovirus, rhinovirus, coronavirus): This is the most common cause of sore throat and cough in children, often presenting with low-grade fever.
  • Other Likely diagnoses:
    • Streptococcal pharyngitis: Although less common than viral causes, streptococcal pharyngitis (strep throat) is a significant consideration due to its potential for complications if not treated.
    • Influenza: Especially during flu season, influenza can present with these symptoms and is more likely to cause a fever.
    • Allergic rhinitis: Can cause cough and sore throat due to postnasal drip, though fever is less common.
  • Do Not Miss diagnoses:
    • Epiglottitis: A rare but life-threatening condition that can cause severe sore throat, difficulty swallowing, and high fever. It requires immediate medical attention.
    • Retropharyngeal abscess: A serious infection in the tissues at the back of the throat, which can cause severe throat pain, difficulty swallowing, and fever.
    • Pertussis (whooping cough): Especially if the cough is severe or has a characteristic whoop, this bacterial infection can be dangerous, especially in younger children or those not fully vaccinated.
  • Rare diagnoses:
    • Mononucleosis (mono): Caused by the Epstein-Barr virus, it can present with sore throat, fever, and fatigue, though it's more common in adolescents.
    • Lemierre's syndrome: A rare condition following a throat infection, characterized by fever, sore throat, and neck pain due to a jugular vein thrombosis.
    • Tuberculosis (TB): Although rare in many areas, TB can cause chronic cough, fever, and sore throat, especially in children who have been exposed to someone with active TB.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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