Differential Diagnosis for Recurrent Fever with Conjunctival Injection
- Single most likely diagnosis
- Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) syndrome: This condition is characterized by recurrent episodes of fever, often accompanied by symptoms such as aphthous stomatitis, pharyngitis, and adenitis. Conjunctival injection can also be present, making it a plausible diagnosis for recurrent fever with this symptom.
- Other Likely diagnoses
- Kawasaki Disease: An acute febrile illness of childhood that presents with fever, conjunctival injection, erythema of the oral and pharyngeal mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Although it's more common in children, it should be considered in the differential diagnosis.
- Reactive Arthritis (Reiter's Syndrome): This form of arthritis occurs as a reaction to an infection elsewhere in the body, often in the gastrointestinal tract or the urethra. Symptoms can include fever, conjunctival injection, and arthritis, among others.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis: Although conjunctival injection is not a primary symptom, in cases of meningitis, especially if caused by Neisseria meningitidis, fever and conjunctival signs can be present. Given the potentially fatal outcome if untreated, it's crucial to consider this diagnosis.
- Endocarditis: Infective endocarditis can present with fever and systemic symptoms, including conjunctival hemorrhages or injection in some cases, particularly if there's an embolic phenomenon.
- Rare diagnoses
- Behçet's Disease: A rare disorder that causes blood vessel inflammation throughout the body, leading to symptoms like recurrent fever, conjunctival injection, and oral or genital ulcers. It's less common but should be considered in patients with a combination of these symptoms.
- Cyclic Neutropenia: A rare blood disorder characterized by recurrent episodes of neutropenia, which can lead to fever, oral ulcers, and possibly conjunctival injection due to secondary infections.