Differential Diagnosis for Fever on and off for 2 weeks in a 6-year-old
Single Most Likely Diagnosis
- Viral Infection: This is the most common cause of intermittent fever in children. Viral infections such as the common cold, influenza, or other respiratory viruses can cause fever that comes and goes over a period of days to weeks.
Other Likely Diagnoses
- Pharyngitis: Caused by either viral or bacterial pathogens, pharyngitis can lead to intermittent fever, especially if the infection is not fully cleared or if it recurs.
- Otitis Media: Middle ear infections are common in children and can cause fever that may seem intermittent, especially if the child has recurrent infections.
- Urinary Tract Infection (UTI): While less common in young boys, UTIs can occur in children of any age and may present with intermittent fever, especially if the infection is not severe.
- Infectious Mononucleosis: Caused by Epstein-Barr virus, this condition can present with fever, sore throat, and fatigue, and the fever can be intermittent.
Do Not Miss Diagnoses
- Meningitis: Although less likely, bacterial meningitis is a medical emergency that requires prompt diagnosis and treatment. It can present with fever, headache, and stiff neck.
- Septic Arthritis or Osteomyelitis: These are serious bacterial infections of the joints or bones that can cause intermittent fever, along with pain and swelling of the affected area.
- Appendicitis: While the classic presentation includes abdominal pain, nausea, and vomiting, some children may have intermittent fever as part of their symptom complex.
- Pneumonia: Bacterial pneumonia can cause high fever, but in some cases, especially in young children, the fever can be intermittent.
Rare Diagnoses
- Juvenile Idiopathic Arthritis (JIA): This chronic autoimmune disease can cause intermittent fever, along with joint pain and swelling.
- Lymphoma: Although rare in children, lymphoma can present with prolonged or intermittent fever, along with weight loss and fatigue.
- Tuberculosis (TB): TB can cause a variety of symptoms, including intermittent fever, especially in children who have been exposed to someone with active TB.
- Endocarditis: An infection of the heart valves, endocarditis is rare in children without heart defects but can cause intermittent fever, among other symptoms.