Differential Diagnosis for a 5-Month-Old Baby with Runny Nose, Fever, Sticking Out Tongue, and Restlessness
- Single Most Likely Diagnosis
- Viral upper respiratory tract infection (URTI): This is the most common cause of runny nose and fever in infants. The symptoms presented are typical for a viral infection, which is often self-limiting but can cause significant distress in young children.
- Other Likely Diagnoses
- Bacterial sinusitis: Although less common in this age group, bacterial sinusitis can occur, especially if the symptoms persist or worsen over time. The presence of fever and nasal discharge could suggest a bacterial infection.
- Teething: Infants around this age may start teething, which can cause irritability, excessive drooling (which might be mistaken for a runny nose), and sometimes a low-grade fever. Sticking out the tongue could be a sign of teething pain.
- Allergic rhinitis: Though less common in infants, allergic reactions to environmental allergens could cause runny nose and restlessness.
- Do Not Miss Diagnoses
- Bacterial meningitis: Although rare, bacterial meningitis is a life-threatening condition that can present with fever, irritability, and sometimes signs of upper respiratory infection. The sticking out of the tongue could be a sign of neurological irritation.
- Sepsis: Any infant with fever and signs of distress should be evaluated for sepsis, a potentially life-threatening condition.
- Epiglottitis: This is a rare but serious condition that can cause significant respiratory distress, fever, and sometimes a muffled voice or difficulty swallowing. It's less likely but critical not to miss.
- Rare Diagnoses
- Congenital anomalies (e.g., choanal atresia): These are rare conditions that could cause chronic nasal discharge and might be considered if the symptoms are persistent and not responsive to typical treatments.
- Immunodeficiency: Infants with immunodeficiencies might be more prone to severe or recurrent infections, presenting with similar symptoms.
- Tumors (e.g., nasopharyngeal tumors): Extremely rare in infants, but could cause nasal obstruction and discharge, along with other systemic symptoms like fever.