Differential Diagnosis for Sores in the Skin with Cough, Signs of Pneumonia, and Fever
Single Most Likely Diagnosis
- Leptospirosis: This diagnosis is highly plausible given the symptoms of skin sores, cough, signs of pneumonia, and fever, especially in the Philippines where leptospirosis is endemic. Leptospirosis can cause a wide range of symptoms, including respiratory issues and skin manifestations.
Other Likely Diagnoses
- Dengue Fever: Common in the Philippines, dengue fever can present with fever, cough, and sometimes a rash or skin sores. While pneumonia is not a typical presentation, secondary infections can occur.
- Tuberculosis (TB): TB is prevalent in the Philippines and can cause chronic cough, fever, and skin lesions in some cases, especially in the context of immunocompromised patients.
- Influenza or other viral pneumonias: These can cause fever, cough, and signs of pneumonia. Skin sores might be less common but could occur as part of a secondary bacterial infection.
Do Not Miss Diagnoses
- Meningococcemia: Although less common, this condition can present with fever, cough (if pneumonia is present), and a characteristic rash that could be mistaken for sores. It's critical to consider this diagnosis due to its high mortality rate if untreated.
- Rickettsial infections (e.g., Scrub Typhus): Endemic in parts of Asia, including the Philippines, these infections can cause fever, headache, and a characteristic eschar at the site of the tick bite, which might be described as a skin sore.
- SARS-CoV-2 (COVID-19): Given the global pandemic, COVID-19 should be considered, especially if the patient has been exposed to someone with the virus. While skin manifestations are less common, they can occur.
Rare Diagnoses
- Melioidosis: Caused by Burkholderia pseudomallei, this infection is rare but can be found in Southeast Asia. It can cause a wide range of symptoms, including skin lesions, pneumonia, and fever.
- Yaws: A tropical disease caused by Treponema pallidum subspecies pertenue, yaws can cause skin lesions and might be considered in the differential diagnosis, especially in children, although it's less likely given the respiratory symptoms.