Differential Diagnosis for a 12-year-old Male with Sore Throat, Left Ear Pain, Runny Nose, and Cough
- Single Most Likely Diagnosis
- Viral upper respiratory tract infection (URTI): This is the most common cause of sore throat, runny nose, and cough in children, and the presence of these symptoms together strongly suggests a viral etiology.
- Other Likely Diagnoses
- Acute otitis media (AOM): The left ear pain could be indicative of AOM, especially if the patient has a history of ear infections or if the pain is severe.
- Pharyngitis (caused by Group A beta-hemolytic streptococcus): Although less common than viral pharyngitis, streptococcal pharyngitis is a significant cause of sore throat in children and requires antibiotic treatment.
- Allergic rhinitis: If the runny nose and cough are accompanied by itchy eyes, sneezing, or a history of allergies, allergic rhinitis could be a contributing factor.
- Do Not Miss Diagnoses
- Epiglottitis: Although rare, epiglottitis is a life-threatening condition that can cause severe sore throat, difficulty swallowing, and respiratory distress. It requires immediate medical attention.
- Peritonsillar abscess: A complication of tonsillitis, a peritonsillar abscess can cause severe sore throat, fever, and difficulty swallowing, and requires prompt drainage.
- Retropharyngeal abscess: Another rare but serious condition, a retropharyngeal abscess can cause sore throat, neck stiffness, and respiratory distress, and requires immediate medical evaluation.
- Rare Diagnoses
- Lemierre's syndrome: A rare condition characterized by pharyngitis followed by a bacterial infection of the jugular vein, Lemierre's syndrome can cause severe sore throat, fever, and neck pain.
- Tuberculosis (TB): Although rare in children, TB can cause chronic cough, sore throat, and other respiratory symptoms, and should be considered in patients with risk factors for TB exposure.
- Infectious mononucleosis: Caused by the Epstein-Barr virus, infectious mononucleosis can cause sore throat, fever, and lymphadenopathy, and should be considered in patients with prolonged or severe symptoms.