Differential Diagnosis for 13-year-old Male with Respiratory and Systemic Symptoms
- Single Most Likely Diagnosis
- Influenza: The patient's symptoms of cough, vomiting, headache (HA), fatigue, fever, sore throat, and sweating are consistent with influenza, especially given the acute onset and the progression of symptoms. The lack of response to benzonatate, which is often used for cough, does not rule out influenza as it primarily targets the cough reflex rather than the underlying viral infection.
- Other Likely Diagnoses
- Acute Viral Pharyngitis: The presence of sore throat and fever could suggest a viral pharyngitis, which is common in adolescents and can present with similar systemic symptoms.
- Viral Gastroenteritis: Although the patient denies diarrhea, the vomiting and nausea could be part of a viral gastroenteritis, especially if the vomiting is not solely attributed to the cough or other respiratory symptoms.
- Common Cold (Upper Respiratory Tract Infection): The initial symptoms of cough and sore throat could be indicative of a common cold, which often includes headache and fatigue, though the fever might be less common.
- Do Not Miss Diagnoses
- Pneumonia: Although the patient denies phlegm and blood in cough, pneumonia can present with non-specific symptoms, especially in children and adolescents, and is crucial to diagnose due to potential severity and need for specific treatment.
- Pertussis (Whooping Cough): Given the cough as a primary symptom, pertussis should be considered, especially if the cough is severe or has a characteristic whoop, though this is less common in vaccinated populations.
- Meningitis: The combination of headache, fever, and vomiting could, in rare cases, suggest meningitis, which is a medical emergency requiring prompt diagnosis and treatment.
- Rare Diagnoses
- Tuberculosis (TB): Although less likely, TB can present with chronic cough, fever, and systemic symptoms. The lack of exposure history does not rule out TB, but it makes it less likely.
- Leptospirosis: This zoonotic infection can cause a wide range of symptoms including fever, headache, and cough, but it is relatively rare and usually associated with specific exposures (e.g., contact with contaminated water).
- Mononucleosis: Caused by Epstein-Barr virus, it can present with sore throat, fever, and fatigue, but typically includes lymphadenopathy and hepatosplenomegaly, which are not mentioned.