Differential Diagnosis for a 4-year-old Male with Persistent Fever after Strep Infection
- Single most likely diagnosis:
- Acute Rheumatic Fever (ARF) or Post-Streptococcal Glomerulonephritis (PSGN) - These conditions are known complications of streptococcal infections and can present with persistent fever among other symptoms.
- Other Likely diagnoses:
- Persistent Strep Infection - The child may not have fully responded to the initial antibiotic treatment, leading to ongoing infection.
- Viral Infection - A concurrent viral infection could be causing the persistent fever.
- Sinusitis or other bacterial infections - These can occur concurrently with or following a streptococcal infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis or Sepsis - Although less common, these conditions are life-threatening and require immediate attention.
- Kidney Abscess or Pyelonephritis - Infections of the urinary tract can spread to the kidneys and are serious conditions.
- Osteomyelitis or Septic Arthritis - Bone and joint infections can occur and have significant morbidity if not promptly treated.
- Rare diagnoses:
- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) - A rare condition associated with streptococcal infections that affects the brain.
- Streptococcal Toxic Shock Syndrome (STSS) - A severe and potentially life-threatening condition, though rare in children.
- Other autoimmune or inflammatory conditions triggered by the streptococcal infection, such as Henoch-Schönlein purpura.