Differential Diagnosis for a 17-Year-Old Male with Pain in the Tip of His Finger, Chills, and Vomiting
Single Most Likely Diagnosis
- Paronychia: This is an infection of the skin around the nail, which can cause pain, redness, and swelling in the tip of the finger. The presence of chills and vomiting may indicate a more severe infection. Given the symptoms, paronychia is a common and plausible diagnosis.
Other Likely Diagnoses
- Herpetic Whitlow: A viral infection caused by herpes simplex virus, leading to painful lesions on the fingers. It can be accompanied by systemic symptoms like chills and vomiting, especially in the initial phase.
- Finger Cellulitis: A bacterial infection of the skin and soft tissues of the finger, which can cause pain, swelling, and redness. Systemic symptoms such as chills and vomiting can occur, especially if the infection is severe.
- Osteomyelitis of the Finger: An infection of the bone in the finger, which can cause localized pain, swelling, and systemic symptoms like chills and vomiting.
Do Not Miss Diagnoses
- Sepsis: Although less likely, sepsis is a life-threatening condition that can arise from any infection, including those of the finger. The presence of chills, vomiting, and severe pain warrants consideration of sepsis, as it requires immediate medical attention.
- Endocarditis: In rare cases, an infection in the finger can lead to endocarditis, an infection of the heart valves, especially in individuals with pre-existing heart conditions. This diagnosis is critical to consider due to its high mortality rate if left untreated.
Rare Diagnoses
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. While it's less likely given the acute presentation with chills and vomiting, it's a consideration in the differential diagnosis for finger pain.
- Raynaud's Phenomenon: A condition that affects blood flow to the fingers and toes, and can cause pain, but it typically does not present with systemic symptoms like chills and vomiting unless there's an associated autoimmune disorder.