Differential Diagnosis
- Single most likely diagnosis
- B. Coxsackie virus: The presence of scattered, 1-mm vesicles on the anterior palatine pillars and gray, shallow ulcers on the soft palate and uvula are characteristic of herpangina, which is most commonly caused by Coxsackie virus. The clinical presentation and the age of the patient also support this diagnosis.
- Other Likely diagnoses
- A. Adenovirus: Adenovirus can cause a similar clinical presentation, including fever, throat pain, and oral ulcers. However, the specific location and appearance of the ulcers in this case are more suggestive of herpangina caused by Coxsackie virus.
- E. Streptococcus pyogenes: Although the patient has throat pain and fever, the presence of vesicles and ulcers on the soft palate and uvula is not typical of streptococcal pharyngitis. However, it is still a possible cause of the patient's symptoms and should be considered.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- D. Herpes simplex virus: Herpes simplex virus can cause oral ulcers, but they are typically more severe and widespread than those described in this case. However, herpes simplex virus infection can be severe and even life-threatening in rare cases, so it should not be missed.
- C. Epstein-Barr virus: Epstein-Barr virus is the cause of infectious mononucleosis, which can present with fever, throat pain, and oral ulcers. Although the patient's symptoms are not typical of infectious mononucleosis, it is a potentially serious condition that should be considered.
- Rare diagnoses
- Other enteroviruses, such as echovirus or enterovirus 71, can cause herpangina or other similar clinical presentations. However, these are less common causes of the patient's symptoms and would not be the first consideration.