Differential Diagnosis for Pediatric Tender Scalp, Fever, and Lymphadenopathy
Single Most Likely Diagnosis
- Tinea capitis: A fungal infection of the scalp, common in children, which can cause tender scalp, fever, and lymphadenopathy due to the body's immune response to the infection.
Other Likely Diagnoses
- Impetigo: A bacterial skin infection that can spread to the scalp, causing tenderness, fever, and lymphadenopathy.
- Folliculitis: An inflammation of the hair follicles, often due to bacterial infection, which can present with similar symptoms.
- Pediatric autoimmune disorders (e.g., Juvenile Idiopathic Arthritis): Although less common, these conditions can cause systemic symptoms including fever and lymphadenopathy, with scalp tenderness due to associated conditions like scalp psoriasis.
Do Not Miss Diagnoses
- Meningitis: Although the primary symptoms are usually related to the central nervous system (e.g., headache, stiff neck), in early or atypical cases, fever and lymphadenopathy could be prominent, with scalp tenderness being a less common symptom.
- Osteomyelitis of the skull: A bone infection that could cause localized pain and tenderness of the scalp, fever, and lymphadenopathy.
- Neuroblastoma with scalp metastasis: A rare but critical diagnosis, as neuroblastoma can cause lymphadenopathy and systemic symptoms like fever, with scalp metastases being a possible, though uncommon, site of disease spread.
Rare Diagnoses
- Kerion: A severe form of tinea capitis that can cause significant inflammation and tenderness of the scalp, often accompanied by fever and lymphadenopathy.
- Aplastic anemia: A condition where the bone marrow fails to produce blood cells, which could lead to infections (including scalp infections) due to immunocompromised state, presenting with fever, lymphadenopathy, and possibly scalp tenderness.
- Langerhans cell histiocytosis: A rare disorder that can cause a variety of symptoms, including scalp lesions, fever, and lymphadenopathy, due to abnormal proliferation of Langerhans cells.