Differential Diagnosis for a 15-year-old with URI symptoms, fever, sore ribs, and calf
- Single most likely diagnosis:
- Influenza: This is a common cause of URI symptoms, fever, and myalgias (muscle pains), which could explain the sore ribs and calf. The presentation is consistent with a viral infection, and influenza is prevalent in the community during certain times of the year.
- Other Likely diagnoses:
- Viral pneumonia: Could present with similar symptoms, including fever, URI symptoms, and chest pain (sore ribs) due to coughing or pleuritic pain.
- Mononucleosis (Mono): Caused by Epstein-Barr virus, it can present with fever, sore throat, fatigue, and myalgias. Although less common, it's a consideration in adolescents.
- Mycoplasma pneumonia: A type of atypical pneumonia that can cause symptoms similar to viral pneumonia, including fever, cough, and chest pain.
- Do Not Miss diagnoses:
- Pulmonary embolism: Although rare in adolescents, it's a life-threatening condition that could cause chest pain and shortness of breath. Risk factors such as recent travel, immobility, or family history of clotting disorders would increase suspicion.
- Bacterial pneumonia: Can present similarly to viral pneumonia but requires prompt antibiotic treatment. Certain bacteria like Streptococcus pneumoniae can cause severe disease.
- Sepsis: A life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Fever, tachycardia, and signs of organ dysfunction would be red flags.
- Rare diagnoses:
- Leptospirosis: A bacterial infection that can cause fever, headache, and muscle aches, including calf pain. It's more common in individuals exposed to contaminated water or soil.
- Lyme disease: Caused by Borrelia burgdorferi, transmitted by tick bites. It can cause fever, headache, fatigue, and muscle pains, but the presence of a rash (erythema migrans) is often a distinguishing feature.
- Osteomyelitis: An infection of the bone that could cause localized pain, fever, and swelling. It's less common but should be considered if there's a history of trauma or if the pain is localized to a specific area.