Differential Diagnosis
The symptoms presented, including bilateral conjunctivitis, white spots on the palate, and erythema of the palate, suggest an infectious or inflammatory process. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus (EBV), it often presents with fever, sore throat, fatigue, and can include symptoms like bilateral conjunctivitis and erythema of the palate. The white spots on the palate could be petechiae, which are sometimes seen in mono.
Other Likely Diagnoses
- Streptococcal Pharyngitis: This bacterial infection can cause a sore throat, fever, and erythema of the palate. While conjunctivitis is not a primary symptom, it can occasionally occur, especially in children.
- Herpangina: Caused by coxsackieviruses, it presents with small, blister-like bumps or ulcers on the roof of the mouth and the back of the throat, which could be mistaken for white spots. It can also cause fever and sore throat.
- Hand, Foot, and Mouth Disease: Although it primarily affects children, it can cause a sore throat and mouth sores, and occasionally, conjunctivitis.
Do Not Miss Diagnoses
- Lemierre's Syndrome: A rare but serious condition that starts with a sore throat and can progress to include symptoms like conjunctivitis due to the spread of infection. It's crucial to identify early due to its potential for severe complications.
- Kawasaki Disease: An acute febrile illness of childhood that can present with conjunctivitis, erythema of the oral and pharyngeal mucosa, and potentially life-threatening cardiac complications if not treated promptly.
Rare Diagnoses
- Behçet's Disease: A form of vasculitis that can cause a wide range of symptoms, including oral ulcers, genital ulcers, and uveitis. While it's rare, it could potentially explain some of the symptoms if they are part of a broader, systemic disease process.
- Pemphigus: An autoimmune disease that causes blistering of the skin and mucous membranes. It could potentially cause oral lesions and, in rare cases, might be associated with conjunctivitis.