Differential Diagnosis for Pediatric Tender Scalp Fever
- Single most likely diagnosis
- Impetigo: This is a common and highly contagious skin infection in children, often presenting with tender, red, and swollen areas on the scalp, accompanied by fever. The presence of golden crusts or pus-filled blisters can further support this diagnosis.
- Other Likely diagnoses
- Folliculitis: An inflammation of the hair follicles, which can be caused by bacterial or fungal infections, leading to tender scalp, fever, and pus-filled bumps.
- Pediculosis (Lice infestation): Although not typically associated with fever, severe cases or secondary infections can lead to systemic symptoms like fever, alongside the characteristic itching and tender scalp.
- Tinea capitis (Ringworm of the scalp): A fungal infection that can cause scalp tenderness, fever, and hair loss, often with a circular, red, and scaly appearance.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis: Although less common, meningitis can present with fever and scalp tenderness, especially if there's associated neck stiffness or neurological symptoms. Early recognition is crucial due to its high mortality rate if left untreated.
- Osteomyelitis of the skull: A bone infection that can cause localized pain, fever, and tenderness, including on the scalp, and requires prompt antibiotic treatment to prevent serious complications.
- Brain abscess: A rare but potentially life-threatening condition that might present with fever, headache, and localized tenderness, including on the scalp, necessitating urgent medical intervention.
- Rare diagnoses
- Kerion: A severe form of tinea capitis that can cause significant scalp inflammation, fever, and lymphadenopathy, often requiring systemic antifungal treatment.
- Discoid lupus erythematosus: An autoimmune condition that can lead to scalp tenderness, fever, and skin lesions, although it's rare in children and typically involves other systemic symptoms.
- Histoplasmosis: A fungal infection that, in rare cases, can cause scalp lesions, fever, and systemic illness, particularly in immunocompromised individuals or those exposed to contaminated soil.