Differential Diagnosis for a 10-year-old Female with Sore Throat
- Single most likely diagnosis:
- Acute Streptococcal Pharyngitis (Strep Throat): This is the most likely diagnosis given the positive rapid strep test, sore throat, decreased appetite, fatigue, low-grade fever, and tonsils with white patches. The symptoms and test results align with the typical presentation of strep throat.
- Other Likely diagnoses:
- Viral Pharyngitis: Although the rapid strep test is positive, it's essential to consider viral pharyngitis as some viruses can cause similar symptoms. However, the presence of white patches on the tonsils and a positive rapid strep test makes this less likely.
- Tonsillitis: This could be a consideration given the tonsillar involvement, but the positive rapid strep test points more towards streptococcal pharyngitis as the primary diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Epiglottitis: Although rare in children due to vaccination, epiglottitis is a life-threatening condition that requires immediate attention. Symptoms can include severe sore throat, difficulty swallowing, and high fever. The absence of severe respiratory distress and the ability to tolerate liquids make this less likely, but it should always be considered.
- Lemierre's Syndrome: This is a rare but serious condition that can follow a throat infection, characterized by jugular vein thrombosis and septicemia. It's crucial to monitor for signs of complications or failure to improve with appropriate treatment.
- Rare diagnoses:
- Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus, mono can present with sore throat, fever, and fatigue. However, it typically includes lymphadenopathy and hepatosplenomegaly, which are not mentioned in the scenario.
- Diphtheria: A bacterial infection that can cause a sore throat and fever, but it's very rare in vaccinated populations and typically includes a distinctive membrane covering the tonsils and throat.