What is the likely diagnosis for an 18-month-old patient presenting with fever, generalized seizures (febrile seizures), lethargy, and upper respiratory symptoms, including rhinorrhea?

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Differential Diagnosis for 18-month-old with Fever and "Full Body Jolts"

  • Single most likely diagnosis:
    • Febrile seizure: The child's symptoms of fever, "full body jolts" (which could be indicative of seizure activity), and increased lethargy are consistent with a febrile seizure, especially given the age of the child. Febrile seizures are common in this age group and are typically triggered by a fever.
  • Other Likely diagnoses:
    • Viral upper respiratory infection: The runny nose and fever suggest a viral upper respiratory infection, which could be contributing to the child's symptoms.
    • Viral gastroenteritis: Although not explicitly mentioned, viral gastroenteritis could also present with fever and lethargy in this age group.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Meningitis: Although less likely, meningitis is a serious and potentially life-threatening condition that can present with fever, lethargy, and seizures. It is crucial to consider this diagnosis, especially if the child's symptoms worsen or if there are other concerning signs such as neck stiffness or bulging fontanelle.
    • Bacterial sepsis: Sepsis is another life-threatening condition that can present with fever, lethargy, and seizures. It is essential to consider this diagnosis, especially if the child appears severely unwell or has a history of underlying medical conditions.
    • Encephalitis: Encephalitis, an inflammation of the brain, can also present with fever, seizures, and lethargy. It is a serious condition that requires prompt diagnosis and treatment.
  • Rare diagnoses:
    • Epilepsy: Although febrile seizures are more common in this age group, it is possible that the child has an underlying seizure disorder such as epilepsy.
    • Metabolic disorders: Certain metabolic disorders, such as pyridoxine-dependent epilepsy, can present with seizures and fever. However, these conditions are rare and would typically require further investigation to diagnose.

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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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