Differential Diagnosis for a Four Year Old Boy with Mild Fever, Neck Soreness, and Limited Head Movement
- Single Most Likely Diagnosis
- Viral meningitis: This condition is characterized by inflammation of the meninges (the protective membranes covering the brain and spinal cord) due to a viral infection. The symptoms of mild fever, soreness in the neck, and difficulty moving the head are consistent with viral meningitis, especially in the absence of other symptoms like ear or nose inflammation, sore throat, or more severe systemic symptoms.
- Other Likely Diagnoses
- Bacterial meningitis: Although less likely than viral meningitis given the mild presentation, bacterial meningitis is a serious condition that requires prompt diagnosis and treatment. Early stages might present with similar symptoms, making it a consideration.
- Torticollis: This condition involves a twisted neck, which could cause soreness and difficulty moving the head. It can be congenital or acquired due to muscle spasms or other causes.
- Cervical lymphadenitis: Inflammation of the lymph nodes in the neck can cause soreness and stiffness, potentially limiting head movement.
- Do Not Miss Diagnoses
- Meningococcal sepsis: A severe, life-threatening condition caused by Neisseria meningitidis. Early symptoms can be non-specific, including fever and neck stiffness, making prompt recognition critical.
- Spinal epidural abscess: A rare but serious condition involving an abscess in the spinal epidural space, which can cause neck pain, stiffness, and neurological deficits.
- Subarachnoid hemorrhage: Although rare in children, a hemorrhage in the space surrounding the brain can cause sudden, severe headache, neck stiffness, and other neurological symptoms.
- Rare Diagnoses
- Kawasaki disease: An acute febrile illness of childhood that can cause cervical lymphadenopathy and neck stiffness among other symptoms.
- Juvenile idiopathic arthritis (JIA): Can cause neck pain and stiffness, especially in the morning, due to inflammation of the joints.
- Osteomyelitis or discitis: Infections of the bone or intervertebral disc, respectively, which can cause localized pain and stiffness, including in the neck region.