Differential Diagnosis for 8-Month-Old with 103°F Fever
Single Most Likely Diagnosis
- Viral upper respiratory tract infection (URTI): This is the most common cause of fever in infants, and at 8 months, the child is likely to have been exposed to various viral pathogens. The high fever is consistent with a viral etiology.
Other Likely Diagnoses
- Bacterial otitis media: Ear infections are common in infants and can cause high fever. The Eustachian tube is shorter and more horizontal in infants, making them more prone to ear infections.
- Urinary tract infection (UTI): UTIs can cause high fever in infants, especially if they are not yet toilet-trained and unable to communicate symptoms like dysuria.
- Gastroenteritis: Viral or bacterial gastroenteritis can cause fever, vomiting, and diarrhea in infants.
- Pneumonia: Lower respiratory tract infections can cause high fever, cough, and respiratory distress in infants.
Do Not Miss Diagnoses
- Bacterial meningitis: Although less common, bacterial meningitis is a life-threatening condition that requires prompt diagnosis and treatment. Infants may present with fever, irritability, and bulging fontanelle.
- Sepsis: Septicemia can cause high fever, lethargy, and poor perfusion in infants. It is essential to consider sepsis in any infant with a high fever, especially if they appear unwell.
- Kawasaki disease: This condition can cause high fever, rash, and lymphadenopathy in infants. If left untreated, it can lead to coronary artery aneurysms.
Rare Diagnoses
- Congenital syphilis: This condition can cause fever, rash, and other systemic symptoms in infants. Although rare, it is essential to consider congenital syphilis in any infant with a high fever and unexplained symptoms.
- Tuberculosis: TB can cause fever, cough, and weight loss in infants. Although rare in developed countries, it is essential to consider TB in infants with a high fever and exposure history.
- Leukemia or lymphoma: These conditions can cause fever, pallor, and lymphadenopathy in infants. Although rare, they are essential to consider in any infant with a high fever and unexplained symptoms.