Differential Diagnosis for 16-month-old Patient
- Single most likely diagnosis
- Hand-foot-and-mouth disease (HFMD): The patient was sent home from daycare for possible HFMD, and the mother reports a pimple-like area on her buttocks, which is consistent with the rash seen in HFMD. The patient's recent history of myringotomy and low-grade fever are also consistent with a viral illness like HFMD.
- Other Likely diagnoses
- Viral gastroenteritis: The patient's symptoms of chronic rhinorrhea and recent low-grade fever could be indicative of a viral gastrointestinal infection.
- Common cold: The patient's symptoms of chronic rhinorrhea could be indicative of a common cold, especially given the recent history of myringotomy, which may have increased her susceptibility to upper respiratory infections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Bacterial sepsis: Although the patient is afebrile, the recent history of myringotomy increases her risk of bacterial infections, and sepsis is a potentially life-threatening condition that must be considered.
- Meningitis: The patient's recent history of myringotomy and symptoms of chronic rhinorrhea could be indicative of a more serious infection like meningitis, especially if the patient is not fully vaccinated.
- Rare diagnoses
- Scarlet fever: The patient's symptoms of a pimple-like rash and recent low-grade fever could be indicative of scarlet fever, although this is less likely given the absence of a characteristic sandpapery rash and strawberry tongue.
- Kawasaki disease: The patient's symptoms of chronic rhinorrhea and recent low-grade fever could be indicative of Kawasaki disease, although this is less likely given the absence of other characteristic symptoms like conjunctivitis and cervical lymphadenopathy.