Differential Diagnosis for a 4-year-old child with high fever, stomach pain, runny nose, and mild cough
- Single most likely diagnosis:
- Viral gastroenteritis or a viral upper respiratory infection with abdominal pain, given the combination of fever, runny nose, mild cough, and stomach pain. The absence of diarrhea makes gastroenteritis less likely, but it's still possible, especially if the child has not been eating or drinking much.
- Other Likely diagnoses:
- Pneumonia: The presence of a high fever and mild cough could suggest pneumonia, especially if the stomach pain is referred pain from the lower lungs.
- Influenza: Given the flu season, influenza could be a likely diagnosis, especially with high fever, runny nose, and mild cough.
- Mesenteric lymphadenitis: This condition, often caused by viral infections, can cause abdominal pain and fever.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although the child's symptoms do not perfectly align with classic appendicitis (e.g., no diarrhea, and the pain pattern is not clearly migratory or localized to the right lower quadrant), appendicitis can present atypically in young children and is a surgical emergency.
- Pneumococcal peritonitis or other bacterial peritonitis: These conditions are less common but can be life-threatening and require prompt antibiotic treatment.
- Sepsis: Any child with a high fever and signs of possible infection should be evaluated for sepsis, a life-threatening condition that requires immediate intervention.
- Rare diagnoses:
- Kawasaki disease: This condition can cause fever, abdominal pain, and other systemic symptoms, although it typically includes more specific findings like rash, conjunctivitis, and lymphadenopathy.
- Systemic juvenile idiopathic arthritis (sJIA): Although rare, sJIA can present with high fevers, abdominal pain, and other systemic symptoms, and it's essential to consider in the differential diagnosis of a child with prolonged fever and abdominal pain without a clear infectious cause.