Differential Diagnosis for Bloody Diarrhea in a 7-year-old Boy
Single most likely diagnosis
- Enterohemorrhagic Escherichia coli (E. coli) infection: This is a common cause of bloody diarrhea in children, especially after traveling to areas with poor sanitation. The patient's recent trip to Central America and the progression from mucoid to bloody stools support this diagnosis.
Other Likely diagnoses
- Shigella infection: Similar to E. coli, Shigella is a common cause of bloody diarrhea, particularly in children who have traveled to areas with poor sanitation.
- Salmonella infection: Salmonella can cause bloody diarrhea, especially in children, and is often associated with travel to areas with poor food and water hygiene.
- Campylobacter infection: Campylobacter is a common cause of gastrointestinal infections, including bloody diarrhea, and can be acquired through contaminated food or water.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intussusception: Although less likely, intussusception is a medical emergency that can cause bloody diarrhea and abdominal pain. It occurs when a part of the intestine telescopes into another part, leading to bowel obstruction and potentially life-threatening complications if not promptly treated.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic bloody diarrhea and abdominal pain. While less common in children, IBD can have serious complications if left untreated.
Rare diagnoses
- Yersinia enterocolitica infection: This bacterial infection can cause bloody diarrhea, but it is less common than other bacterial causes.
- Amebic dysentery: Caused by Entamoeba histolytica, this parasitic infection can lead to bloody diarrhea, but it is relatively rare in developed countries and typically associated with travel to endemic areas.
- Food poisoning from other pathogens: Other less common pathogens like Clostridium perfringens or Staphylococcus aureus can cause food poisoning leading to bloody diarrhea, although these are less likely given the patient's symptoms and travel history.