Differential Diagnosis for Headache with Fever
The following differential diagnosis is organized into categories to help guide the thought process:
- Single Most Likely Diagnosis
- Viral upper respiratory tract infection (e.g., common cold, influenza): This is often the most common cause of headache and fever due to the high prevalence of viral infections and their typical presentation with these symptoms.
- Other Likely Diagnoses
- Sinusitis: An infection or inflammation of the sinuses can cause headache and fever, especially if the headache is localized to the facial area.
- Meningitis: Although less common, meningitis is a significant concern and can present with headache, fever, and stiff neck.
- Tension headache with coincidental fever: Sometimes, a tension headache can occur in the context of a fever from a separate, less serious cause.
- Do Not Miss Diagnoses
- Bacterial meningitis: This is a medical emergency that requires prompt diagnosis and treatment. It presents with headache, fever, and stiff neck, and can lead to severe complications or death if not treated promptly.
- Encephalitis: An inflammation of the brain, usually due to a viral infection, which can present with headache, fever, confusion, and altered mental status.
- Subarachnoid hemorrhage: Although typically not associated with fever, in some cases, especially if there's an associated infection, it could be considered. It's a life-threatening condition that requires immediate medical attention.
- Brain abscess: A rare but potentially life-threatening condition that can present with headache, fever, and focal neurological signs.
- Rare Diagnoses
- Temporal arteritis: An inflammation of the blood vessels in the head, which can cause headache and fever, especially in older adults.
- Neurosyphilis: A complication of syphilis that can cause a variety of neurological symptoms, including headache and fever.
- Cerebral vasculitis: Inflammation of the blood vessels in the brain, which can cause headache, fever, and various neurological symptoms.
Each of these diagnoses has a brief justification based on the combination of headache and fever as presenting symptoms. The categorization helps in prioritizing the most likely and critical diagnoses that should not be missed.