Differential Diagnosis for a 2-year-old Girl with Vomiting for 4 Days
- Single most likely diagnosis:
- Gastroenteritis: This is the most common cause of vomiting in children, often caused by viral infections, and typically presents with diarrhea, fever, and abdominal cramps in addition to vomiting.
- Other Likely diagnoses:
- Food poisoning: Bacterial or viral infections from contaminated food can cause vomiting, and the symptoms can last for several days.
- Urinary Tract Infection (UTI): Although more common in older children, UTIs can cause vomiting, especially if the infection has ascended to the kidneys.
- Appendicitis: Early appendicitis can present with vomiting, and while it's less common in very young children, it's essential to consider, especially if there's abdominal pain.
- Otitis media: Middle ear infections can cause vomiting, possibly due to pain or associated fever.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Intussusception: A condition where a part of the intestine slides into another, which can cause severe abdominal pain, vomiting, and potentially lead to bowel ischemia if not treated promptly.
- Volvulus: A twisting of a portion of the intestine that can cut off blood flow and lead to tissue death, presenting with severe abdominal pain and vomiting.
- Meningitis: Although less likely to present solely with vomiting, meningitis is a life-threatening condition that requires immediate diagnosis and treatment.
- Pyloric stenosis: A condition where the pylorus muscle thickens, blocking food from entering the small intestine, leading to projectile vomiting, typically in infants but can occasionally be seen in toddlers.
- Rare diagnoses:
- Metabolic disorders: Certain metabolic conditions, such as congenital adrenal hyperplasia or disorders of amino acid metabolism, can present with vomiting among other symptoms.
- Increased intracranial pressure: Conditions like brain tumors or hydrocephalus can cause vomiting, often accompanied by other neurological signs.
- Foreign body ingestion: Although not typically causing prolonged vomiting, if the object obstructs the gastrointestinal tract, it could lead to persistent vomiting.