Differential Diagnosis for a Child with Facial Flushing, Swelling, 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 and swelling could be indicative of a flare-up or active disease process, especially if the child has a history of joint involvement.
Other Likely Diagnoses
- Kawasaki Disease: Characterized by fever, rash, swelling of hands and feet, conjunctivitis, and cervical lymphadenopathy. Facial flushing and swelling are key components, and while abdominal pain and headaches are not primary symptoms, they can occur.
- Systemic Lupus Erythematosus (SLE): An autoimmune disease that can present with a wide range of symptoms including fevers, abdominal pain, headaches, and facial rashes or swelling. It's less common in children but should be considered, especially with a strong family history.
- Infectious Mononucleosis: Caused by Epstein-Barr virus, it can lead to fever, abdominal pain (due to splenomegaly), and headaches. Facial swelling, particularly if there's significant lymphadenopathy, could be part of the presentation.
Do Not Miss Diagnoses
- Meningitis: Although the primary symptoms don't directly suggest meningitis, headaches and fevers could be indicative of this serious condition. It's crucial to assess for signs of meningismus (stiff neck, photophobia) and consider lumbar puncture if suspected.
- Appendicitis: Abdominal pain is a key symptom, and while the other symptoms might not directly point to appendicitis, it's a condition that requires prompt surgical intervention to prevent serious complications.
- Neuroblastoma: A pediatric cancer that can cause a variety of systemic symptoms including fevers, abdominal pain (if the tumor is in the abdomen), and headaches. Facial flushing could be related to catecholamine secretion by the tumor.
Rare Diagnoses
- Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Some types can lead to easy bruising, poor wound healing, and potentially symptoms like abdominal pain and headaches, though facial flushing and swelling would be less typical.
- Autoinflammatory Disorders (e.g., PFAPA Syndrome): Characterized by recurrent episodes of fever, often accompanied by other symptoms like abdominal pain, headaches, and sometimes facial swelling or rash. These are rare but important to consider in children with periodic fevers and other systemic symptoms.