Differential Diagnosis for 13-year-old with Cough and Sore on Tongue
- Single most likely diagnosis:
- Viral pharyngitis: This is the most common cause of a sore tongue and cough in a 13-year-old, often accompanied by other symptoms like fever and sore throat.
- Other Likely diagnoses:
- Bacterial pharyngitis (Strep throat): Although less common than viral pharyngitis, it's a significant consideration due to the potential for complications if left untreated.
- Allergic rhinitis: Postnasal drip from allergies can cause cough and irritation to the tongue and throat.
- Acid reflux (Gastroesophageal reflux disease, GERD): Stomach acid flowing up into the throat can cause irritation and soreness, potentially leading to cough.
- Do Not Miss diagnoses:
- Infectious mononucleosis: Although less common, it can present with sore throat and could be accompanied by a cough, with the additional risk of splenomegaly and other complications.
- Pertussis (Whooping cough): Given the cough symptom, pertussis is a critical diagnosis not to miss, especially in areas with low vaccination rates or outbreaks.
- Oral thrush: Especially if the patient is immunocompromised, oral thrush can cause a sore tongue and should be considered to ensure appropriate antifungal treatment.
- Rare diagnoses:
- Autoimmune disorders (e.g., pemphigus, lupus): These can cause oral ulcers and potentially a cough if there's pulmonary involvement, though they are much less common.
- Leukemia or lymphoma: These conditions can cause a wide range of symptoms including sore throat and cough, and although rare, are critical to diagnose early.
- Behçet's disease: A rare condition that can cause oral ulcers and potentially other symptoms like cough if there's pulmonary involvement.