Differential Diagnosis for a 6-year-old Boy with Sore Throat and Ear Pain
Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most common cause of sore throat in children, often accompanied by ear pain due to referred pain or concurrent viral otitis media. The symptoms of sore throat and ear pain for 3 days are consistent with a viral upper respiratory infection.
Other Likely Diagnoses
- Streptococcal Pharyngitis: Although less common than viral pharyngitis, streptococcal (strep) throat is a significant cause of sore throat in children and can be accompanied by ear pain. It's essential to consider this diagnosis due to the need for antibiotic treatment to prevent complications.
- Otitis Media: This is an infection of the middle ear and is a common cause of ear pain in children. It can be caused by bacteria or viruses and may be accompanied by sore throat if there is concurrent pharyngitis.
- Tonsillitis: Inflammation of the tonsils can cause sore throat and may be accompanied by ear pain. Tonsillitis can be viral or bacterial in origin.
Do Not Miss Diagnoses
- Retropharyngeal Abscess: Although rare, this condition is a medical emergency that requires prompt diagnosis and treatment. It can cause severe throat pain, difficulty swallowing, and ear pain due to the abscess's proximity to the eustachian tube.
- Peritonsillar Abscess: This is a collection of pus behind the tonsils that can cause severe sore throat, difficulty swallowing, and ear pain. It requires prompt medical attention and drainage of the abscess.
- Epiglottitis: This is a rare but life-threatening condition that causes inflammation of the epiglottis, potentially leading to airway obstruction. Symptoms can include sore throat, ear pain, difficulty swallowing, and shortness of breath.
Rare Diagnoses
- Lemierre's Syndrome: A rare condition characterized by a bacterial infection of the tonsils followed by the spread of the infection to the jugular vein, causing a thrombophlebitis. It can present with sore throat, ear pain, and fever.
- Tuberculous Lymphadenitis: Although rare in many parts of the world, tuberculosis can cause lymph node swelling in the neck, which might be accompanied by sore throat and ear pain due to the proximity of the infected nodes to the throat and ear structures.
- Juvenile Idiopathic Arthritis (JIA): Some forms of JIA can present with sore throat and ear pain among other systemic symptoms, although this would be an uncommon initial presentation.