Differential Diagnosis for 10-month-old Male with Fever and Left Shoulder Pain
- Single most likely diagnosis
- Septic arthritis of the left shoulder: The patient's presentation of fever, swelling, erythema, and pain in the left shoulder, along with the inability to move the left upper extremity, is highly suggestive of septic arthritis. The elevated ESR and CRP, as well as the leukocytosis with a left shift, further support this diagnosis.
- Other Likely diagnoses
- Osteomyelitis: The patient's symptoms of fever, pain, and swelling in the left shoulder could also be consistent with osteomyelitis, an infection of the bone. The elevated inflammatory markers and leukocytosis support this possibility.
- Cellulitis or soft tissue infection: The patient's presentation of erythema, swelling, and pain in the left shoulder could also be consistent with a soft tissue infection, such as cellulitis. However, the severity of the patient's symptoms and the inability to move the left upper extremity make septic arthritis or osteomyelitis more likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis: Although the patient does not have any symptoms suggestive of meningitis, such as headache or stiff neck, it is essential to consider this diagnosis in a febrile child with severe symptoms. Meningitis can be deadly if not promptly diagnosed and treated.
- Sepsis: The patient's fever, tachycardia, and leukocytosis could be indicative of sepsis, a life-threatening condition that requires prompt recognition and treatment.
- Necrotizing fasciitis: This is a rare but deadly condition that can present with severe pain, swelling, and erythema. Although it is unlikely, it is essential to consider this diagnosis in a patient with severe symptoms.
- Rare diagnoses
- Rheumatologic conditions, such as juvenile idiopathic arthritis: Although these conditions are rare in infants, they can present with fever, joint pain, and swelling.
- Bone tumors, such as osteosarcoma: These tumors are rare in infants, but they can present with pain, swelling, and fever.
- Infectious diseases, such as Lyme disease or tuberculosis: These conditions are rare in infants, but they can present with fever, joint pain, and swelling.