Differential Diagnosis for a 4-year-old with Multiple Tick Bites and Fever
- Single most likely diagnosis:
- Lyme disease: This is a common tick-borne illness that can cause fever, headache, and a characteristic "bull's-eye" rash. The presence of multiple tick bites increases the risk of transmission.
- Other Likely diagnoses:
- Southern tick-associated rash illness (STARI): This condition is also transmitted by tick bites and can cause a similar rash to Lyme disease, although it is typically less severe.
- Ehrlichiosis: A bacterial infection transmitted by ticks, which can cause fever, headache, and fatigue.
- Anaplasmosis: Another tick-borne bacterial infection that can cause similar symptoms to ehrlichiosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Rocky Mountain spotted fever (RMSF): A severe and potentially life-threatening tick-borne illness that requires prompt treatment.
- Tularemia: A rare but serious bacterial infection that can be transmitted by tick bites, which can cause fever, skin ulcers, and pneumonia.
- Rare diagnoses:
- Babesiosis: A parasitic infection transmitted by ticks, which can cause fever, anemia, and other symptoms, particularly in individuals with weakened immune systems.
- Powassan virus disease: A rare but potentially severe tick-borne viral illness that can cause fever, headache, and encephalitis.
- Tick-borne relapsing fever: A rare bacterial infection transmitted by soft ticks, which can cause recurring episodes of fever and other symptoms.