Differential Diagnosis for a 4-year-old with a Scuffed Palm and Red, Streaked, Itchy Wrist
- Single most likely diagnosis:
- Cellulitis: This is the most likely diagnosis given the redness, streaking towards the wrist, and itchiness. Cellulitis is a common bacterial skin infection that can occur after a skin injury, such as a fall, and can cause redness, swelling, and warmth of the skin.
- Other Likely diagnoses:
- Contact dermatitis: This could be a possible diagnosis if the child's skin reacted to something on the road or to a substance used for cleaning the wound. Itchiness is a hallmark of contact dermatitis.
- Impetigo: A contagious skin infection that can cause red sores on the skin and can be itchy. It often occurs on the face but can spread to other areas of the body.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Tetanus: Although less common, especially in vaccinated children, tetanus infection can occur through wounds contaminated with tetanus spores. It's crucial to ensure the child's tetanus vaccination is up to date.
- Sepsis: Any infection that spreads beyond the initial site can potentially lead to sepsis, a life-threatening condition. Early recognition and treatment are critical.
- Rare diagnoses:
- Erysipelas: A type of skin infection that can cause redness and swelling, typically affecting the face or lower extremities but can occur elsewhere. It's less common in children and usually requires specific bacterial infections.
- Lymphangitis: An infection of the lymphatic vessels, which can cause red streaks from the site of infection towards the lymph nodes. It's less common and usually associated with more severe infections.