What is the diagnosis for a 15-year-old patient with fever, conjunctivitis, rhinorrhea, and a recent history of international travel, who presents with bilateral conjunctivitis, small white spots on the palate, and erythema, after exposure to a cousin with similar symptoms and a rash?

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Differential Diagnosis

  • Single most likely diagnosis
    • Measles: The patient's symptoms, including fever, conjunctivitis, runny nose, and the presence of small white spots on the palate (Koplik spots), are highly suggestive of measles. The recent international travel and exposure to a cousin with similar symptoms, including a rash, further support this diagnosis.
  • Other Likely diagnoses
    • Influenza: The patient's symptoms of fever, runny nose, and conjunctivitis could also be consistent with influenza, although the presence of Koplik spots and the specific constellation of symptoms make measles more likely.
    • Adenoviral infection: Adenovirus can cause a range of symptoms, including fever, conjunctivitis, and respiratory symptoms, but the presence of Koplik spots and the patient's exposure history make this diagnosis less likely.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Meningitis: Although the patient's symptoms do not specifically suggest meningitis, the presence of fever and conjunctivitis could be indicative of a more serious infection. Meningitis is a potentially life-threatening condition that requires prompt diagnosis and treatment.
    • Sepsis: The patient's fever and systemic symptoms could be indicative of sepsis, a life-threatening condition that requires immediate attention.
  • Rare diagnoses
    • Scarlet fever: The patient's symptoms, including fever and erythema of the palate, could be consistent with scarlet fever, although the presence of Koplik spots and the patient's exposure history make this diagnosis less likely.
    • Kawasaki disease: The patient's symptoms, including fever and conjunctivitis, could be consistent with Kawasaki disease, although the absence of other characteristic symptoms, such as lymphadenopathy and desquamation, make this diagnosis less likely.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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