What is the diagnosis for a 14-year-old patient with a sore throat, recent Streptococcus exposure, and positive COVID-19 test?

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Last updated: March 26, 2025View editorial policy

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Differential Diagnosis for 14-year-old with Sore Throat and Recent Strep Exposure

  • Single most likely diagnosis:
    • COVID-19: The patient has tested positive for COVID-19, which is consistent with the symptoms of mild nasal congestion, rhinorrhea, and sore throat. The recent exposure to strep could be a red herring, and the COVID-19 diagnosis takes precedence.
  • Other Likely diagnoses:
    • Viral pharyngitis: The symptoms of sore throat, nasal congestion, and rhinorrhea are consistent with a viral pharyngitis, which could be caused by a variety of viruses, including coronaviruses, rhinoviruses, and adenoviruses.
    • Streptococcal pharyngitis: Although the patient has tested positive for COVID-19, the recent exposure to strep and the worsening discomfort in the throat with sneezing and swallowing could still suggest streptococcal pharyngitis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Epiglottitis: This is a rare but life-threatening condition that can cause severe sore throat, difficulty swallowing, and shortness of breath. Although the patient's symptoms are mild, epiglottitis should be considered, especially if the patient's condition worsens.
    • Peritonsillar abscess: This is a rare but serious complication of tonsillitis that can cause severe sore throat, difficulty swallowing, and fever. Although the patient has not reported any fever or difficulty swallowing, peritonsillar abscess should be considered if the patient's condition worsens.
  • Rare diagnoses:
    • Infectious mononucleosis: This is a rare condition caused by the Epstein-Barr virus that can cause sore throat, fever, and fatigue. Although the patient's symptoms are mild, infectious mononucleosis should be considered if the patient's condition worsens or if other symptoms develop.
    • Lemierre's syndrome: This is a rare condition caused by a bacterial infection that can cause sore throat, fever, and neck pain. Although the patient's symptoms are mild, Lemierre's syndrome should be considered if the patient's condition worsens or if other symptoms develop.

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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