Differential Diagnosis for Illness with Sore Throat, Vomiting, and Fever
Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most common cause of sore throat and is often accompanied by fever and vomiting, especially in children. The presence of these symptoms, particularly during peak viral season, makes viral pharyngitis a leading consideration.
Other Likely Diagnoses
- Strep Throat (Streptococcal Pharyngitis): Caused by Group A beta-hemolytic streptococcus, this bacterial infection presents with sore throat, fever, and can be associated with vomiting, especially in children. A rapid strep test or throat culture can help confirm the diagnosis.
- Influenza: Although primarily known for causing respiratory symptoms, influenza can also lead to sore throat, fever, and gastrointestinal symptoms like vomiting, particularly in severe cases or in certain populations.
- Mononucleosis (Infectious Mononucleosis): Caused by Epstein-Barr virus, this illness can present with sore throat, fever, and sometimes vomiting, along with fatigue and lymphadenopathy.
Do Not Miss Diagnoses
- Epiglottitis: A potentially life-threatening condition that can cause sore throat, fever, and vomiting, along with difficulty swallowing and shortness of breath. Prompt recognition and treatment are crucial to prevent airway obstruction.
- Retropharyngeal Abscess: An infection in the tissues at the back of the throat, which can cause severe sore throat, fever, vomiting, and difficulty swallowing. It requires urgent medical attention to prevent complications like airway obstruction.
- Meningitis: Although less directly associated with sore throat, meningitis can cause fever, vomiting, and sometimes throat pain due to the inflammatory process. Its rapid progression and potential for severe outcomes make it a critical diagnosis not to miss.
Rare Diagnoses
- Lemierre's Syndrome: A rare condition characterized by a bacterial infection of the throat, which can lead to sore throat, fever, and vomiting, followed by the development of a jugular vein thrombosis and septic emboli.
- Diphtheria: A bacterial infection that can cause a severe sore throat, fever, and sometimes vomiting, along with a characteristic membrane covering the tonsils and throat. It's rare in areas with high vaccination coverage but can be seen in unvaccinated individuals or during outbreaks.
- Tularemia: A rare bacterial infection that can present with sore throat, fever, and vomiting, among other symptoms, depending on the route of infection. It's more commonly associated with skin ulcers or pneumonia but can have pharyngeal involvement.