What is the diagnosis for a 41-year-old patient with a past medical history (PMH) of thyroid cancer, presenting with a sore throat, fever, rash on the right side of the face, increased sweating, and oral thrush (little white patches on the tongue), after recently changing lotion?

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Differential Diagnosis

  • Single Most Likely Diagnosis
    • Contact dermatitis: The patient's report of a new lotion and a rash on the right side of her face, which she thinks may be caused by laying on her pillow or the new lotion, suggests a contact dermatitis. The rash's location and the patient's recent change in lotion make this a plausible explanation.
  • Other Likely Diagnoses
    • Viral pharyngitis: The patient's symptoms of sore throat and fever are consistent with a viral pharyngitis, which could be caused by a variety of viruses.
    • Thrush (oral candidiasis): The little white patches on the patient's tongue could be indicative of thrush, especially given her history of thyroid cancer and potential immunocompromised state.
    • Allergic reaction: The patient's rash and symptoms could also be indicative of an allergic reaction to the new lotion or another substance.
  • Do Not Miss Diagnoses
    • Infectious mononucleosis: Although less likely, infectious mononucleosis can cause sore throat, fever, and rash, and can be severe if left untreated.
    • Lemierre's syndrome: This rare but potentially life-threatening condition is characterized by a sore throat, fever, and rash, and can progress to sepsis if not treated promptly.
    • Thyroid storm: Given the patient's history of thyroid cancer, a thyroid storm is a potentially life-threatening condition that could be triggered by an infection or other stressor.
  • Rare Diagnoses
    • Kawasaki disease: This rare condition is characterized by fever, rash, and swollen lymph nodes, and can be severe if left untreated.
    • Stevens-Johnson syndrome: This rare but potentially life-threatening condition is characterized by a severe rash, blisters, and mucosal involvement, and can be triggered by an infection or allergic reaction.

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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