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Differential Diagnosis for an 8-year-old with Intermittent Fevers for 2 Months

Single Most Likely Diagnosis

  • Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus (EBV), it's common in children and can present with intermittent fevers, fatigue, and lymphadenopathy. The prolonged duration of symptoms fits this diagnosis.

Other Likely Diagnoses

  • Juvenile Idiopathic Arthritis (JIA): This condition can cause intermittent fevers, joint pain, and swelling. It's a common rheumatologic condition in children.
  • Tuberculosis (TB): Although less common in some regions, TB can cause chronic or intermittent fevers, especially if it's extrapulmonary. Exposure history and travel are important considerations.
  • Recurrent Infections: Children with immune deficiencies or anatomical issues (e.g., urinary tract abnormalities) might experience recurrent infections leading to intermittent fevers.

Do Not Miss Diagnoses

  • Malignancies (e.g., Leukemia, Lymphoma): These are critical to identify early due to their severe prognosis if left untreated. Symptoms can include intermittent fevers, weight loss, and fatigue.
  • Endocarditis: Although rare in healthy children, it's a life-threatening condition that can cause intermittent fevers, especially if there's a history of heart disease.
  • Osteomyelitis or Septic Arthritis: These conditions can present with fever and localized pain, and it's crucial to diagnose them promptly to prevent long-term damage.

Rare Diagnoses

  • Periodic Fever Syndromes (e.g., PFAPA Syndrome): These are rare genetic disorders characterized by recurrent episodes of fever without an obvious cause.
  • Cystic Fibrosis: While primarily known for respiratory and gastrointestinal symptoms, cystic fibrosis can also cause recurrent fevers due to chronic infections.
  • Chronic Granulomatous Disease (CGD): A rare immune deficiency that makes it hard for the body to kill certain bacteria and fungi, leading to recurrent infections and fevers.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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