What is the differential diagnosis for a 15-year-old patient presenting with upper respiratory infection (URI) symptoms, fever, and pain in the ribs and calf?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 7, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

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.
  • Other Likely diagnoses
    • Viral pharyngitis: Similar to influenza, viral pharyngitis can cause URI symptoms and fever, with possible referred pain to the chest and legs due to coughing or systemic inflammation.
    • Mononucleosis: Caused by Epstein-Barr virus, it can present with fever, sore throat, and myalgias, although the sore ribs might also suggest splenomegaly, which is sometimes associated with this condition.
    • Musculoskeletal strain: Overexertion or strain could cause soreness in the ribs and calf, especially if the patient has been engaging in physical activities.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Pneumonia: Although less likely, pneumonia can cause fever, URI symptoms, and pleuritic chest pain (sharp pain when breathing, which might be perceived as sore ribs).
    • Sepsis: A severe, life-threatening condition that can arise from an infection, presenting with fever, and potentially muscle pain due to systemic inflammation.
    • Osteomyelitis or septic arthritis: Infections of the bone or joint, respectively, which could cause localized pain and fever, although these would be less common presentations.
  • Rare diagnoses
    • Leukemia or lymphoma: These can cause systemic symptoms including fever and bone pain due to marrow involvement, although they are much less common and would typically be accompanied by other signs such as weight loss, fatigue, or lymphadenopathy.
    • Familial Mediterranean Fever: A genetic disorder that causes recurrent episodes of fever and painful inflammation, often in the abdomen, chest, or joints, which could potentially explain the sore ribs and calf, though it's rare and typically presents earlier in life.

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.