Differential Diagnosis for a 14-Month-Old Child with a Painful Oral Lesion on the Lips
- Single Most Likely Diagnosis
- Herpes Simplex Virus (HSV) infection: This is a common cause of painful oral lesions in children, especially at this age. The presentation of vesicular lesions that rupture to form ulcers is typical for HSV.
- Other Likely Diagnoses
- Hand, Foot, and Mouth Disease (HFMD): Caused by viruses like Coxsackievirus A, this condition can present with oral lesions, although they are typically accompanied by lesions on the hands and feet.
- Traumatic Oral Ulcers: Accidental bites or other traumas can cause painful lesions on the lips or inside the mouth.
- Aphthous Ulcers: Although more common in older children, aphthous ulcers (canker sores) can occur in younger children and present as painful oral lesions.
- Do Not Miss Diagnoses
- Erythema Multiforme: A skin condition that can be triggered by infections (including HSV) and medications, characterized by target lesions, which can involve the mucous membranes and be very painful.
- Stevens-Johnson Syndrome: A severe form of skin and mucous membrane disorder, usually a reaction to medication or infection, which can be life-threatening and requires immediate medical attention.
- Oral Candidiasis (Thrush): While typically not painful, in severe cases or when associated with other conditions, it can cause significant discomfort and should be considered, especially if the child is immunocompromised or has been on antibiotics.
- Rare Diagnoses
- Autoimmune Disorders (e.g., Pemphigus Vulgaris): These are rare conditions that can cause blistering lesions in the mouth and on the skin.
- Leukemia or Lymphoma: Although extremely rare, these conditions can cause oral lesions and should be considered if other systemic symptoms are present or if the child does not respond to typical treatments.
- Congenital or Acquired Immunodeficiency: Children with immunodeficiencies may be more prone to unusual or severe infections that could present with oral lesions.