Differential Diagnosis for a 2-year-old with Recurrent Localized Red Cheek Unilateral Fluctuating
- Single most likely diagnosis
- Parotid gland infection or parotitis: This condition is common in children and can cause recurrent, localized redness and swelling of the cheek, often unilateral. The fluctuating nature suggests an abscess or a collection of pus.
- Other Likely diagnoses
- Erythema infectiosum (Fifth disease): Although it typically presents with a "slapped-cheek" appearance, it can cause unilateral redness and is common in children.
- Contact dermatitis: This could cause localized redness and irritation, especially if the child has come into contact with an allergen or irritant on one side of the face.
- Impetigo: A highly contagious bacterial skin infection that can cause red, crusty sores and can appear on the face, potentially causing unilateral symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cellulitis: A bacterial skin infection that can spread rapidly and cause serious complications if not treated promptly. It can present with redness, swelling, and warmth of the skin.
- Osteomyelitis of the facial bones: Although rare, this infection of the bone can cause localized redness, swelling, and pain, and requires prompt treatment to prevent serious complications.
- Orbital cellulitis: An infection of the tissues surrounding the eye, which can cause redness, swelling, and protrusion of the eye, and can lead to serious complications if not treated promptly.
- Rare diagnoses
- Sarcoidosis: A condition that can cause skin lesions, including on the face, but is rare in young children.
- Lupus erythematosus: An autoimmune disease that can cause a butterfly-shaped rash on the face, but is uncommon in children as young as 2 years old.
- Angioedema: A condition that causes swelling of the skin and mucous membranes, which can be unilateral and affect the face, but is less common in this age group without a clear trigger.