Differential Diagnosis for a Single Whitish Spot at the Base of the Tonsil with High Fever in a 4-Year-Old Kid
- Single Most Likely Diagnosis
- Tonsillitis (likely bacterial, such as Streptococcal pharyngitis): This is a common condition in children, characterized by inflammation of the tonsils, often presenting with fever, sore throat, and sometimes a whitish exudate at the base of the tonsils.
- Other Likely Diagnoses
- Herpangina: Caused by Coxsackie viruses, it presents with small, whitish or yellowish vesicles or ulcers at the back of the throat, including the base of the tonsils, accompanied by fever and sore throat.
- Infectious Mononucleosis (Mono): Although more common in adolescents, it can occur in younger children, presenting with fever, sore throat, and sometimes exudative tonsillitis.
- Peritonsillar Abscess: A complication of tonsillitis where an abscess forms beside the tonsils, which can appear as a whitish swelling and is accompanied by severe sore throat, fever, and difficulty swallowing.
- Do Not Miss Diagnoses
- Diphtheria: A serious bacterial infection that can cause a thick, whitish or greyish membrane to form at the back of the throat, including the tonsils, and is accompanied by fever and sore throat. Although rare in areas with high vaccination coverage, it's crucial not to miss due to its potential severity.
- 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, characterized by high fever, neck pain, and swelling.
- Rare Diagnoses
- Histoplasmosis: A fungal infection that can cause symptoms similar to tonsillitis, including a whitish spot at the base of the tonsil, but is less common and usually associated with exposure to bird or bat droppings.
- Tuberculosis (TB): Although rare in children, TB can manifest in the tonsils, presenting with chronic symptoms such as a whitish spot, fever, and weight loss. It's essential to consider in children with risk factors for TB exposure.