Differential Diagnosis for 12-year-old Patient
Single Most Likely Diagnosis
- Viral Upper Respiratory Tract Infection (URTI): The patient's symptoms of cough, congestion, sore throat, and ear pain, which have been present for 3-4 days, are consistent with a viral URTI. The fact that the patient has been taking ibuprofen and Teraflu with some relief also supports this diagnosis.
Other Likely Diagnoses
- Streptococcal Pharyngitis: The patient's sore throat and fever (reported as feeling warm) could be indicative of streptococcal pharyngitis, which is a common cause of sore throat in children.
- Allergic Rhinitis: The patient's congestion and cough could be related to allergic rhinitis, especially if the symptoms are persistent and not entirely relieved by ibuprofen and Teraflu.
- Otitis Media: The patient's ear pain could be indicative of otitis media, which is a common complication of URTI in children.
Do Not Miss Diagnoses
- Retropharyngeal Abscess: Although less likely, a retropharyngeal abscess could present with similar symptoms, including sore throat and neck pain. This condition requires prompt medical attention to prevent serious complications.
- Lymphoma or Other Malignancy: The patient's long-standing discoloration of the neck, which has not responded to OTC ointments, could be a sign of a more serious underlying condition, such as lymphoma or other malignancy.
- Kawasaki Disease: This condition, which is characterized by fever, rash, and lymphadenopathy, could be considered in the differential diagnosis, especially if the patient's symptoms worsen or do not respond to treatment.
Rare Diagnoses
- Tuberculosis: Although rare in children, tuberculosis could present with similar symptoms, including cough, fever, and lymphadenopathy.
- Sarcoidosis: This condition, which is characterized by granulomatous inflammation, could present with lymphadenopathy and skin discoloration, although it is rare in children.
- Histoplasmosis: This fungal infection could present with similar symptoms, including cough, fever, and lymphadenopathy, although it is rare in children and typically requires exposure to contaminated soil or bird droppings.