Differential Diagnosis

The patient presents with fever, dry cough, and refusal to eat, which are non-specific symptoms that can be associated with various conditions. Here's a categorized differential diagnosis:

• Single most likely diagnosis
  • Viral upper respiratory tract infection (URTI): The patient's symptoms of fever, dry cough, and refusal to eat are consistent with a viral URTI, which is a common and self-limiting condition. The recent completion of an antibiotic course for an infected wisdom tooth and the lack of severe symptoms or signs of bacterial infection make this diagnosis more likely.
• Other Likely diagnoses
  • Bacterial pharyngitis: Although the patient recently completed an antibiotic course, bacterial pharyngitis is still a possibility, especially if the antibiotic course was not fully effective or if the patient was exposed to a new bacterial pathogen.
  • Influenza: The patient's symptoms of fever, cough, and refusal to eat could be consistent with influenza, especially during the flu season.
  • Gastroesophageal reflux disease (GERD): The patient's refusal to eat and dry cough could be related to GERD, especially if the patient has a history of picky eating and has been experiencing discomfort or pain while eating.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pneumonia: Although the patient's respiratory examination is normal, pneumonia is a potentially life-threatening condition that should not be missed. The patient's dry cough and refusal to eat could be early signs of pneumonia.
  • Epiglottitis: This is a rare but life-threatening condition that requires prompt recognition and treatment. The patient's refusal to eat and dry cough could be signs of epiglottitis, especially if the patient has a history of recent antibiotic use.
  • Severe acute respiratory syndrome (SARS): Although rare, SARS is a potentially life-threatening condition that should be considered, especially if the patient has a history of recent travel or exposure to someone with SARS.
• Rare diagnoses
  • Pertussis (whooping cough): The patient's dry cough could be consistent with pertussis, especially if the patient has not been vaccinated or has been exposed to someone with pertussis.
  • Cystic fibrosis: Although rare, cystic fibrosis is a genetic disorder that can present with respiratory and gastrointestinal symptoms, including cough and refusal to eat.
  • Immunodeficiency: The patient's history of autism and picky eating could be related to an underlying immunodeficiency, which would increase the risk of infections and other complications.