Differential Diagnosis for 20yo Male with Cough, Fever, Conjunctivitis, and Erythematous Maculopapular Rash
- Single Most Likely Diagnosis
- Adenovirus Infection: This diagnosis is likely due to the combination of symptoms such as cough, fever, conjunctivitis, and a maculopapular rash, which are commonly seen in adenovirus infections. The pattern of the rash spreading from the hairline down to the face and trunk is also consistent with adenovirus.
- Other Likely Diagnoses
- Measles: Although less common in vaccinated populations, measles can present with a similar constellation of symptoms including cough, fever, conjunctivitis, and a maculopapular rash that spreads from the head down to the trunk.
- Influenza with a Rash: While less typical, influenza can occasionally be associated with a rash, and the initial symptoms of cough and fever could fit this diagnosis.
- Do Not Miss Diagnoses
- Meningococcemia: This is a life-threatening condition that can present with fever, rash, and conjunctivitis. The rash in meningococcemia is typically petechial or purpuric, but early stages can be maculopapular. It's crucial to consider this diagnosis due to its high mortality rate if not promptly treated.
- Kawasaki Disease: Although more common in children under 5, Kawasaki disease can occur in young adults and presents with fever, conjunctivitis, rash, and other symptoms. It's a do-not-miss diagnosis due to the risk of coronary artery aneurysms if not treated.
- Rare Diagnoses
- Scarlet Fever: Caused by Group A beta-hemolytic streptococci, scarlet fever can present with a rash, fever, and sometimes a cough, but it typically includes a distinctive "strawberry tongue" and the rash is more of a fine, sandpapery texture.
- Erythema Infectiosum (Fifth Disease): This illness, caused by parvovirus B19, is characterized by a "slapped-cheek" appearance followed by a maculopapular rash on the trunk and limbs. It's more common in children but can occur in adults, especially if they are immunocompromised or have not been exposed previously.