Differential Diagnosis for a 6-year-old with Purulent Penile Discharge and Fever
- Single most likely diagnosis:
- Urinary Tract Infection (UTI): This is a common condition in children that can cause symptoms such as fever and purulent discharge, especially if the infection involves the urethra.
- Other Likely diagnoses:
- Balanitis: An inflammation of the glans penis, which can be caused by infection, and is a common cause of penile discharge in children.
- Phimosis: A condition where the foreskin cannot be fully retracted over the glans penis, which can lead to accumulation of smegma and potentially cause infection.
- Urethritis: Inflammation of the urethra, which can be caused by infection and result in discharge and fever.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Testicular torsion: Although this condition typically presents with acute testicular pain, it's a surgical emergency and must be considered in the differential diagnosis of any acute scrotal or penile condition.
- Epididymitis: Inflammation of the epididymis, which can be caused by bacterial infection and requires prompt treatment to prevent complications.
- Sexually Transmitted Infections (STIs): Although less common in this age group, STIs such as gonorrhea or chlamydia can cause urethritis and must be considered, especially if there's a suspicion of sexual abuse.
- Rare diagnoses:
- Fixed drug eruption: A rare condition that can cause lesions and potentially discharge on the genital area in response to certain medications.
- Behçet's disease: A rare form of vasculitis that can cause genital ulcers and potentially other symptoms like fever, though it's extremely uncommon in children.
- Granuloma inguinale: A rare STI caused by Klebsiella granulomatis, which can cause ulcerative lesions on the genitals.