Differential Diagnosis for Fever in a Toddler
Single Most Likely Diagnosis
- Viral upper respiratory tract infection: This is the most common cause of fever in toddlers, often accompanied by other symptoms such as cough, runny nose, and sore throat, but can sometimes present with fever alone.
Other Likely Diagnoses
- Ear infection (otitis media): A common cause of fever in toddlers, often accompanied by ear pain, irritability, and sometimes discharge if the eardrum has ruptured.
- Urinary tract infection (UTI): Can cause fever, and other symptoms might include dysuria, frequency, or abdominal pain, though these may be absent in non-verbal toddlers.
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, leading to fever, vomiting, and diarrhea.
- Pneumonia: An infection of the lungs that can cause fever, cough, and difficulty breathing.
Do Not Miss Diagnoses
- Meningitis: An infection of the membranes surrounding the brain and spinal cord, which can present with fever, headache, stiff neck, and altered consciousness. It's critical to diagnose early due to its high morbidity and mortality.
- Sepsis: A life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Fever is a key symptom, along with signs of organ dysfunction.
- Bacteremia: The presence of bacteria in the blood, which can lead to sepsis or focal infections like meningitis or osteomyelitis.
- Kawasaki disease: An acute febrile illness of childhood characterized by fever, rash, swelling of hands and feet, conjunctivitis, and cervical lymphadenopathy. If untreated, it can lead to coronary artery aneurysms.
Rare Diagnoses
- Juvenile idiopathic arthritis (JIA): A chronic autoimmune disease that can cause fever, joint pain, and swelling.
- Lymphoma or leukemia: Types of cancer that can cause prolonged fever, among other symptoms like weight loss, fatigue, and lymphadenopathy.
- Tuberculosis: A bacterial infection that can cause fever, cough, weight loss, and night sweats, though it's less common in toddlers without known exposure.
- Endocarditis: An infection of the heart valves, which can cause fever, heart murmur, and signs of heart failure, though it's rare in toddlers without underlying heart disease.