Differential Diagnosis for a Child with Facial Flushing, Low-Grade Fevers, Abdominal Pain, and Headaches
Single Most Likely Diagnosis
- Juvenile Idiopathic Arthritis (JIA): This condition is a common cause of systemic symptoms such as low-grade fevers, abdominal pain, and headaches in children. Facial flushing can be associated with the systemic inflammation seen in JIA.
Other Likely Diagnoses
- Infectious Mononucleosis: Caused by Epstein-Barr virus, this infection can present with fever, abdominal pain (due to splenomegaly), and headaches. Facial flushing is not a typical symptom but can occur due to the systemic nature of the illness.
- Kawasaki Disease: Although more commonly associated with high fevers, Kawasaki disease can present with low-grade fevers initially and includes symptoms like facial flushing (due to the rash), abdominal pain, and headaches.
- Systemic Lupus Erythematosus (SLE): A chronic autoimmune disease that can cause a wide range of symptoms including fevers, abdominal pain, headaches, and facial rashes or flushing due to the malar rash characteristic of SLE.
Do Not Miss Diagnoses
- Neuroblastoma: A type of cancer that can cause systemic symptoms such as low-grade fevers, abdominal pain (due to tumor location), and headaches. Facial flushing can occur due to catecholamine secretion by the tumor.
- Appendicitis: While typically presenting with acute abdominal pain, some cases can have a more insidious onset with low-grade fevers and systemic symptoms. It's crucial to consider appendicitis to avoid missing this potentially life-threatening condition.
- Meningitis: In its early stages, meningitis can present with non-specific symptoms such as headaches, low-grade fevers, and abdominal pain. Facial flushing is not typical but can occur due to the systemic response to infection.
Rare Diagnoses
- Carney-Stratakis Syndrome: A rare genetic disorder characterized by gastrointestinal stromal tumors (GISTs), paragangliomas, and pulmonary chondromas. It can present with systemic symptoms due to the secretion of catecholamines by paragangliomas, including facial flushing.
- Pheochromocytoma: A rare tumor of the adrenal gland that secretes catecholamines, leading to symptoms such as headaches, abdominal pain, and facial flushing due to hypertension and systemic effects of excess catecholamines.