Differential Diagnosis for Sore Throat with Fever
Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most common cause of sore throat with fever, often due to viruses such as rhinovirus, coronavirus, adenovirus, or influenza. The justification for this diagnosis is the high prevalence of viral infections in the community and the typical presentation of sore throat, fever, and other upper respiratory symptoms.
Other Likely Diagnoses
- Streptococcal Pharyngitis (Strep Throat): Caused by Group A beta-hemolytic streptococcus, this condition presents with severe sore throat, fever, and can be differentiated from viral pharyngitis by the presence of tonsillar exudates, swollen and tender lymph nodes, and the absence of cough. It's a common bacterial cause that requires antibiotic treatment to prevent complications.
- Infectious Mononucleosis: Caused by Epstein-Barr virus, this condition can present with sore throat, fever, fatigue, and lymphadenopathy. It's more common in adolescents and young adults.
- Acute Tonsillitis: This can be caused by both viral and bacterial pathogens and presents with inflammation of the tonsils, sore throat, and fever.
Do Not Miss Diagnoses
- Lemierre's Syndrome: A rare but potentially life-threatening condition caused by Fusobacterium necrophorum, presenting with sore throat, fever, and subsequent sepsis and thrombophlebitis of the internal jugular vein. It's crucial to consider this diagnosis due to its high morbidity and mortality if not promptly treated.
- Peritonsillar Abscess: A complication of tonsillitis, where an abscess forms beside the tonsils, causing severe sore throat, fever, and difficulty swallowing. It requires urgent drainage and antibiotic treatment.
Rare Diagnoses
- Diphtheria: A bacterial infection caused by Corynebacterium diphtheriae, characterized by a sore throat, fever, and a pseudomembrane covering the tonsils and throat. It's rare in areas with high vaccination coverage but can be deadly if not treated promptly.
- Gonococcal Pharyngitis: Caused by Neisseria gonorrhoeae, this condition presents with sore throat and fever, often in the context of a sexually transmitted infection. It's an important consideration in sexually active individuals with a new onset of sore throat.