Differential Diagnosis for 23-month-old Female
- Single most likely diagnosis
- Acute otitis media (AOM): The patient's presentation of fever, irritability, and decreased appetite, along with the finding of a red left tympanic membrane (TM), is highly suggestive of AOM, a common condition in young children.
- Other Likely diagnoses
- Viral upper respiratory infection (URI): The patient's symptoms of fever, decreased appetite, and irritability could also be consistent with a viral URI, which is a common illness in children.
- Pharyngitis: Although the parents deny significant cough, the patient's fever and irritability could also be indicative of pharyngitis, possibly caused by a viral or bacterial pathogen.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Bacterial meningitis: Although the patient is tolerating oral liquids and solids, and there is no mention of severe headache, stiff neck, or other concerning symptoms, bacterial meningitis is a potentially life-threatening condition that must be considered in the differential diagnosis of any febrile child.
- Sepsis: The patient's fever and irritability could also be indicative of sepsis, a life-threatening condition that requires prompt recognition and treatment.
- Retropharyngeal abscess: Although the patient is not pulling at her throat, a retropharyngeal abscess is a potentially life-threatening condition that can cause fever, irritability, and decreased appetite in young children.
- Rare diagnoses
- Juvenile idiopathic arthritis (JIA): Although less likely, JIA can cause fever, irritability, and decreased appetite in young children, and should be considered in the differential diagnosis if other more common conditions are ruled out.
- Kawasaki disease: This rare condition can cause fever, irritability, and decreased appetite in young children, and is characterized by specific clinical criteria, including rash, conjunctivitis, and cervical lymphadenopathy.