Differential Diagnosis for a 5-year-old with Sore Throat, Runny Nose, Congestion, Productive Cough, and Postnasal Drip
- Single Most Likely Diagnosis
- Viral upper respiratory tract infection (URTI): This is the most common cause of the symptoms described, especially given the duration of one week and the age of the patient. Viral URTIs are highly prevalent in children and typically present with a combination of sore throat, runny nose, congestion, cough, and postnasal drip.
- Other Likely Diagnoses
- Allergic rhinitis: This condition could present with similar symptoms, especially if the child is exposed to allergens. However, the presence of a productive cough might lean more towards an infectious cause.
- Sinusitis: Given the symptoms of congestion and postnasal drip, sinusitis is a possible diagnosis, especially if the symptoms persist or worsen over time.
- Influenza: Although the symptoms could be consistent with influenza, the diagnosis would depend on the time of year, exposure history, and possibly rapid testing.
- Do Not Miss Diagnoses
- Bacterial pharyngitis (Strep throat): Although less common than viral causes, streptococcal pharyngitis is a critical diagnosis to consider due to the potential for complications like rheumatic fever if left untreated. A throat swab or rapid strep test can help diagnose this condition.
- Epiglottitis: This is a rare but potentially life-threatening condition that requires immediate medical attention. Symptoms can include a severe sore throat, difficulty swallowing, and respiratory distress.
- Pneumonia: While the primary symptoms suggest an upper respiratory infection, pneumonia should be considered, especially if the child has a high fever, difficulty breathing, or if the cough is severe.
- Rare Diagnoses
- Pertussis (Whooping cough): Although vaccination has reduced the incidence, pertussis can still occur, especially in areas with low vaccination rates or in children who are not fully vaccinated. The characteristic whoop sound during coughing is often but not always present.
- Mycoplasma pneumoniae infection: This bacterium can cause pneumonia and upper respiratory symptoms, especially in school-aged children. It's more commonly considered in older children and adolescents but can occur in younger children as well.
- Foreign body aspiration: This is an emergency situation where an object is inhaled into the airways, which could present with sudden onset of coughing and respiratory distress. It's less likely given the duration of symptoms but should be considered if there's a history suggestive of aspiration.