What is the most likely diagnosis for a child with fever, purulent nasal secretions, and facial tenderness?

In children presenting with fever, purulent nasal secretions, and facial tenderness, the most likely diagnosis is sinusitis. This condition is characterized by inflammation and swelling of the sinus cavities, often following a viral upper respiratory infection. When the sinuses become blocked and filled with pus, it leads to symptoms such as fever and purulent nasal discharge.

Facial tenderness is particularly indicative of sinus involvement, as pain may be felt over the areas where the sinuses are located, such as the forehead or cheeks. The presence of purulent secretions differentiates sinusitis from other upper respiratory infections, where nasal discharge may be more clear or watery.

Other conditions like the common cold, otitis media, and pharyngitis can also cause fever and nasal symptoms; however, they typically do not present with the characteristic facial tenderness associated with sinusitis. A common cold usually involves milder symptoms and does not typically result in significant sinus tenderness. Otitis media would focus more on ear-related symptoms, while pharyngitis would primarily cause sore throat symptoms rather than facial pain and purulent nasal drainage. Thus, in the context of the presented symptoms, sinusitis is the most fitting diagnosis.