Differential Diagnosis for Gingivostomatitis and High-Grade Fever in a 10-Year-Old Girl
Single Most Likely Diagnosis
- Herpetic Gingivostomatitis: This condition, caused by the herpes simplex virus (HSV), is characterized by painful ulcers in the mouth, gums, and throat, along with fever. It is common in children and matches the symptoms described.
Other Likely Diagnoses
- Streptococcal Pharyngitis: Although it primarily causes throat infections, streptococcal pharyngitis can lead to high fever and, in some cases, oral ulcers or gingivitis, especially if the infection spreads.
- Hand, Foot, and Mouth Disease (HFMD): Caused by viruses like coxsackievirus A, HFMD can present with oral ulcers, fever, and sometimes involvement of the gums, though it more commonly affects the hands and feet.
- Acute Necrotizing Ulcerative Gingivitis (ANUG): This condition is characterized by severe gum inflammation and ulceration, often accompanied by fever. It's less common in children but can occur, especially with poor oral hygiene.
Do Not Miss Diagnoses
- Lemierre's Syndrome: A rare but serious condition that starts with a sore throat and can progress to a life-threatening infection of the jugular vein. Early symptoms can include high fever and oral pain.
- Epiglottitis: Although more commonly associated with severe throat pain and difficulty swallowing, epiglottitis can present with fever and, in rare cases, oral ulcers. It's a medical emergency due to the risk of airway obstruction.
- Kawasaki Disease: An acute febrile illness that can cause oral changes, including redness and swelling of the gums, along with high fever. It's a significant diagnosis to consider due to its potential for cardiac complications.
Rare Diagnoses
- Aphthous Stomatitis: While common, when severe, it can mimic gingivostomatitis. However, it typically doesn't cause high-grade fever.
- Autoimmune Disorders (e.g., Pemphigus, Lupus): These conditions can cause oral ulcers and systemic symptoms, including fever, but are rare in children and would require specific diagnostic testing.
- Leukemia: Certain types of leukemia can cause gum infiltration and oral ulcers, along with systemic symptoms like fever. Though rare, it's a critical diagnosis not to miss due to its severe implications.