Differential Diagnosis for a 6-year-old Female with Vomiting, SOB, Diarrhea, Stomach Aches, Coughing, Erythematous Throat, and Swollen Tonsils
- Single Most Likely Diagnosis
- Viral pharyngitis: This is the most likely diagnosis given the combination of symptoms such as vomiting, diarrhea, stomach aches, coughing, erythematous throat, and swollen tonsils, especially with negative Strep and flu tests. Viral pharyngitis is a common condition in children and can be caused by various viruses.
- Other Likely Diagnoses
- Adenovirus infection: Adenoviruses can cause a range of symptoms including gastrointestinal issues, respiratory symptoms, and pharyngitis, making it a plausible diagnosis.
- Respiratory syncytial virus (RSV) infection: Although more common in younger children, RSV can cause symptoms such as coughing, vomiting, and diarrhea in older children, especially during peak season.
- Influenza (despite negative test): False negatives can occur, especially if the test is done too early or too late in the course of the illness. Clinical judgment may still suggest influenza, especially during flu season.
- Do Not Miss Diagnoses
- Epiglottitis: Although rare, epiglottitis is a life-threatening condition that requires immediate attention. Symptoms can include severe sore throat, difficulty swallowing, and shortness of breath.
- Pneumonia: Given the symptoms of coughing and shortness of breath, pneumonia should be considered, especially if there are any signs of respiratory distress or if the child appears severely ill.
- Appendicitis: Abdominal pain and vomiting could also suggest appendicitis, which is a surgical emergency. The presence of diarrhea and the nature of the abdominal pain would need careful evaluation.
- Rare Diagnoses
- Kawasaki disease: This condition can present with fever, sore throat, and gastrointestinal symptoms, among others. It's rare but important to consider due to its potential for cardiac complications.
- Infectious mononucleosis (mono): Caused by Epstein-Barr virus, mono can present with sore throat, fever, and swollen tonsils, but it's less common in young children.
- Lemierre's syndrome: A rare condition characterized by pharyngitis followed by a bacterial infection of the jugular vein, leading to sepsis. It's crucial to consider in cases of severe or persistent pharyngitis.