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Differential Diagnosis for 18 Month Old Girl with Fever, Cough, and Sore Throat

Single Most Likely Diagnosis

  • Viral Pharyngitis: This is the most common cause of sore throat in children, often accompanied by fever and cough, and is usually self-limiting. The presentation of fever, cough, and sore throat for 3 days in an 18-month-old girl is consistent with a viral upper respiratory infection.

Other Likely Diagnoses

  • Acute Bronchiolitis: Given the age of the child and the symptoms of fever and cough, acute bronchiolitis, often caused by respiratory syncytial virus (RSV), is a plausible diagnosis, especially if there are signs of respiratory distress or wheezing.
  • Pneumonia: Community-acquired pneumonia should be considered, especially if the child has a high fever, cough, and signs of respiratory distress. The sore throat could be an accompanying symptom.
  • Influenza: Influenza can present with fever, cough, and sore throat, and its likelihood depends on the time of year and the child's vaccination status.

Do Not Miss Diagnoses

  • Epiglottitis: Although rare, epiglottitis is a medical emergency that can present with sore throat, fever, and cough, but typically progresses to severe respiratory distress. It's crucial to consider this diagnosis due to its potential for airway obstruction.
  • Retropharyngeal Abscess: This condition can cause sore throat, fever, and cough, and is a medical emergency due to the risk of airway compromise.
  • Bacterial Tracheitis: Similar to epiglottitis, bacterial tracheitis is a serious condition that can present with symptoms of upper respiratory infection but can rapidly progress to severe respiratory distress.

Rare Diagnoses

  • Lemierre's Syndrome: A rare condition characterized by bacterial pharyngitis followed by septic thrombophlebitis of the internal jugular vein, which can present with sore throat, fever, and cough, along with neck pain and swelling.
  • Tuberculosis (TB): Although rare in young children in many parts of the world, TB can cause chronic cough, fever, and sore throat, among other symptoms. The diagnosis should be considered based on exposure history and risk factors.
  • Mononucleosis: Caused by Epstein-Barr virus, mononucleosis can present with sore throat, fever, and cough, but is less common in children under the age of 2.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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