Differential Diagnosis for a 12-year-old boy with worsening facial swelling
- Single most likely diagnosis
- Allergic reaction to amoxicillin: The patient was recently prescribed amoxicillin for acute pharyngitis, and the symptoms of facial swelling, burning sensation, scratchy throat, and scattered wheals are consistent with an allergic reaction to the medication.
- Other Likely diagnoses
- Insect bite or sting allergy: The patient's symptoms could be due to an allergic reaction to an insect bite or sting, which is a common cause of facial swelling and wheals in children.
- Food allergy: Although there is no clear history of food ingestion, a food allergy could be considered as a possible cause of the patient's symptoms, especially if the patient has a known history of food allergies.
- Viral urticaria: The patient's symptoms of wheals and facial swelling could be due to a viral infection, which is a common cause of urticaria in children.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Anaphylaxis: Although the patient's symptoms are not currently severe enough to suggest anaphylaxis, this diagnosis should be considered due to the potential for rapid progression and life-threatening consequences.
- Angioedema: The patient's symptoms of facial swelling and tightness in the throat could be due to angioedema, which can be a life-threatening condition if not recognized and treated promptly.
- Rare diagnoses
- Hereditary angioedema: This is a rare genetic disorder that can cause recurrent episodes of angioedema, which could be considered in this patient if other causes are ruled out and the patient has a family history of the condition.
- Serum sickness: This is a rare immune-mediated reaction that can occur in response to certain medications or infections, which could be considered in this patient if other causes are ruled out and the patient has a history of recent infection or medication use.