Differential Diagnosis for a 4-year-old child with high fever, stomach pain, runny nose, mild cough, and lethargy
- Single most likely diagnosis:
- Viral gastroenteritis or a viral upper respiratory infection with abdominal symptoms. The intermittent high fever, runny nose, mild cough, and stomach pain are common in viral infections, and the absence of diarrhea does not rule out gastroenteritis, as it can sometimes present with abdominal pain without diarrhea.
- Other Likely diagnoses:
- Pneumonia: Although the cough is mild, pneumonia can present with high fever, lethargy, and abdominal pain due to referred pain from the lower lungs.
- Urinary Tract Infection (UTI): UTIs can cause high fever, abdominal pain (if the infection involves the kidneys), and lethargy. The fact that the child is peeing properly does not rule out a UTI.
- Influenza: Influenza can cause high fever, runny nose, cough, and body aches, which might be perceived as stomach pain in a child.
- Do Not Miss diagnoses:
- Appendicitis: Although less common in young children, appendicitis is a surgical emergency that can present with abdominal pain, fever, and lethargy. The absence of typical symptoms like vomiting or diarrhea does not rule out appendicitis.
- Bacterial meningitis or sepsis: These are life-threatening conditions that can present with high fever, lethargy, and nonspecific symptoms. Early recognition and treatment are crucial.
- Pneumococcal peritonitis: This is an infection of the lining of the abdominal cavity and can present with fever, abdominal pain, and lethargy.
- Rare diagnoses:
- Kawasaki disease: This is an autoimmune condition that can cause high fever, abdominal pain, and lethargy, among other symptoms. It's rare but important to consider due to its potential for cardiac complications.
- Systemic juvenile idiopathic arthritis (sJIA): This condition can present with high fever, abdominal pain, and lethargy, although it is less common in this age group and typically has other associated symptoms like rash or joint pain.