Differential Diagnosis for a 3-year-old with a 104°F Fever
Single Most Likely Diagnosis
- Viral upper respiratory tract infection (e.g., common cold, flu): This is the most common cause of fever in children of this age group, often presenting with additional symptoms such as cough, runny nose, and sore throat.
Other Likely Diagnoses
- Bacterial pharyngitis (e.g., strep throat): A common cause of fever in children, typically accompanied by a sore throat and possibly a rash.
- Otitis media (ear infection): A frequent cause of fever in young children, often associated with ear pain, irritability, and sometimes vomiting.
- Urinary tract infection (UTI): More common in girls, UTIs can cause fever, dysuria, and abdominal pain.
- Gastroenteritis (stomach flu): Characterized by fever, vomiting, diarrhea, and abdominal cramps.
Do Not Miss Diagnoses
- Meningitis: Although less common, meningitis is a life-threatening condition that requires immediate attention. Symptoms can include fever, headache, stiff neck, and altered mental status.
- Sepsis: A severe and potentially life-threatening condition that occurs when the body's response to an infection becomes uncontrolled and causes widespread inflammation.
- Pneumonia: Can range from mild to severe, pneumonia is an infection of the lungs that can cause fever, cough, and difficulty breathing.
- Appendicitis: Although more common in older children and adults, appendicitis can occur in young children, presenting with fever, abdominal pain, and vomiting.
Rare Diagnoses
- Kawasaki disease: An acute febrile illness of unknown cause that primarily affects children, characterized by fever, rash, swelling of the hands and feet, and conjunctivitis.
- Juvenile idiopathic arthritis (JIA): A chronic autoimmune disease that can cause fever, joint pain, and swelling.
- Leukemia or lymphoma: Although rare, these cancers can present with fever, among other symptoms such as weight loss, fatigue, and bruising.
- Tuberculosis (TB): A bacterial infection that can cause fever, cough, and weight loss, more common in areas with high TB prevalence.