Differential Diagnosis for a 4-year-old with Respiratory Symptoms
- Single most likely diagnosis:
- Viral upper respiratory infection (URI): This is the most likely diagnosis given the symptoms of nasal congestion, cough, sore throat, and fever, which are common in viral URIs. The negative rapid strep test and the presence of a viral panel pending also support this diagnosis.
- Other Likely diagnoses:
- Influenza: Given the acute onset of symptoms such as fever, cough, and sore throat, influenza is a plausible diagnosis, especially during flu season.
- Adenovirus infection: This virus can cause a range of symptoms including fever, sore throat, and vomiting, making it a possible diagnosis.
- Rhinovirus infection: As a common cause of the common cold, rhinovirus could be responsible for the symptoms presented.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Bacterial meningitis: Although less likely given the current symptoms, bacterial meningitis is a critical diagnosis that must be considered, especially with fever and vomiting.
- Epiglottitis: This condition, although rare, is a medical emergency that can present with sore throat, fever, and vomiting, and must be ruled out.
- Pneumonia: Given the cough and fever, pneumonia is a potential diagnosis that could be life-threatening if not treated promptly.
- Rare diagnoses:
- Kawasaki disease: This condition can present with fever, sore throat, and vomiting, but is less common and typically includes other specific criteria such as rash, conjunctivitis, and changes to the lips and oral cavity.
- Mononucleosis: Although more common in older children and adolescents, mononucleosis can cause sore throat, fever, and fatigue, and should be considered in the differential diagnosis.