What is the cause of a sore throat with chills for 3 days, with a negative streptococcal (strep) test result?

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Differential Diagnosis for Sore Throat with Chills

  • The patient presents with sore throat and chills for 3 days, with a negative strep test.

Single Most Likely Diagnosis

  • Viral Pharyngitis: This is the most likely diagnosis, as the majority of sore throats are caused by viral infections, and the patient has already tested negative for strep throat. Viral pharyngitis is often accompanied by symptoms such as chills, fever, and sore throat.

Other Likely Diagnoses

  • Influenza: The patient's symptoms of sore throat and chills could be indicative of influenza, especially during flu season. Influenza is a common cause of sore throat and can be accompanied by systemic symptoms such as chills and fever.
  • Mononucleosis: Although less common, mononucleosis (caused by Epstein-Barr virus) can present with sore throat, fever, and chills, especially in young adults.
  • Acute Trauma or Irritation: The patient may have experienced some form of trauma or irritation to the throat, such as shouting, screaming, or an allergic reaction, which could cause a sore throat.

Do Not Miss Diagnoses

  • Epiglottitis: Although rare, epiglottitis is a potentially life-threatening condition that requires prompt diagnosis and treatment. It can present with sore throat, difficulty swallowing, and systemic symptoms such as chills and fever.
  • Lemierre's Syndrome: This is a rare but serious condition caused by a bacterial infection, typically Fusobacterium necrophorum, which can present with sore throat, fever, and chills, and can progress to more severe complications if left untreated.
  • Retropharyngeal Abscess: This is a rare but potentially life-threatening condition that can present with sore throat, difficulty swallowing, and systemic symptoms such as chills and fever.

Rare Diagnoses

  • Toxoplasmosis: Although rare, toxoplasmosis can cause a sore throat, especially in immunocompromised individuals.
  • Cytomegalovirus (CMV) Infection: CMV infection can cause a sore throat, especially in immunocompromised individuals or those who have received an organ transplant.
  • Human Immunodeficiency Virus (HIV) Acute Retroviral Syndrome: In rare cases, HIV infection can present with sore throat, fever, and chills during the acute retroviral syndrome phase.

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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