Differential Diagnosis for Watery Eye and Fever
- Single most likely diagnosis
- Viral conjunctivitis: This is the most common cause of a watery eye and fever, often accompanied by redness and itching. It's highly contagious and usually resolves on its own.
- Other Likely diagnoses
- Bacterial conjunctivitis: Similar to viral conjunctivitis but often presents with a thicker, more purulent discharge. It requires antibiotic treatment.
- Allergic conjunctivitis: Typically occurs in individuals with a history of allergies, presenting with itchy, watery eyes, and sometimes fever, especially during peak allergy seasons.
- Sinusitis: Inflammation of the sinuses can lead to watery eyes due to the proximity of the sinuses to the tear ducts, and it often presents with fever and facial pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Orbital cellulitis: A serious infection of the tissues surrounding the eye, which can lead to severe complications, including vision loss and spread of infection to the brain. It presents with fever, swelling, and redness around the eye.
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. It's a medical emergency that can result in blindness if not promptly treated.
- Meningitis: Although less directly related to the eye symptoms, in cases where fever is high and accompanied by severe headache, stiff neck, or altered mental status, meningitis must be considered due to its high mortality rate if untreated.
- Rare diagnoses
- Sjögren's syndrome: An autoimmune disorder that can cause dry eyes but sometimes presents with watery eyes due to inflammation, along with fever and other systemic symptoms.
- Cavernous sinus thrombosis: A rare but potentially life-threatening condition that can cause fever, eye symptoms, and neurological deficits due to a blood clot in the cavernous sinus.
- Leptospirosis: A bacterial infection that can cause a wide range of symptoms, including fever, headache, and eye inflammation, although it's less common in many parts of the world.