Differential Diagnosis for Pediatric Condition with Spots on Hands and Fever
- Single Most Likely Diagnosis
- Hand, Foot, and Mouth Disease (HFMD): This is a common viral illness in children, characterized by fever, rash, and sores on the hands and feet. The presence of spots on hands along with fever makes HFMD a leading consideration due to its prevalence and matching symptoms.
- Other Likely Diagnoses
- Scarlet Fever: Caused by Group A beta-hemolytic streptococci, it presents with a rash, fever, and sometimes a "strawberry tongue." The rash can appear on various parts of the body, including the hands.
- Kawasaki Disease: An acute febrile illness of childhood, characterized by fever, rash, swelling of hands and feet, conjunctivitis, and cervical lymphadenopathy. The rash and fever, along with potential hand involvement, make it a plausible diagnosis.
- Roseola: A viral infection causing high fever and a rash that appears as the fever breaks. While the rash is more commonly seen on the trunk, it can spread to other areas, including the hands.
- Do Not Miss Diagnoses
- Meningococcemia: A severe infection caused by Neisseria meningitidis, which can present with fever, rash (often petechial or purpuric), and can rapidly progress to sepsis or meningitis. The rash can appear anywhere on the body, including the hands, and is a medical emergency.
- Rocky Mountain Spotted Fever (RMSF): A tick-borne illness caused by Rickettsia rickettsii, characterized by fever, headache, and a rash that can appear on the hands and feet. It's critical to consider RMSF due to its severity and the need for prompt antibiotic treatment.
- Rare Diagnoses
- Enteroviral infections other than HFMD (e.g., Coxsackievirus A6 causing acute hemorrhagic conjunctivitis or other rashes): While less common, other enteroviruses can cause rashes and fever, and their presentation can sometimes mimic HFMD.
- Erythema multiforme: An immune-mediated condition that can be triggered by infections or medications, characterized by target-like lesions on the skin. It's less likely but should be considered in the differential due to its distinctive rash.