Differential Diagnosis for a 2-year-old Girl with Vomiting and Diarrhea for 4 Days
- Single most likely diagnosis:
- Viral gastroenteritis: This is the most common cause of vomiting and diarrhea in children, often caused by rotavirus, norovirus, or adenovirus. The symptoms and duration are consistent with a viral etiology.
- Other Likely diagnoses:
- Bacterial gastroenteritis: Caused by bacteria such as E. coli, Salmonella, or Shigella, which can lead to similar symptoms.
- Food poisoning: Consuming contaminated food can cause vomiting and diarrhea.
- Lactose intolerance or other dietary intolerances: Could lead to gastrointestinal symptoms, although less common in this age group.
- 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 bloody stools. Although less common, it's a medical emergency.
- Appendicitis: Inflammation of the appendix, which can present with vomiting, diarrhea, and abdominal pain. Early diagnosis is crucial to prevent rupture.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis, which can cause chronic gastrointestinal symptoms but may present acutely.
- Urinary tract infection (UTI): Especially in young girls, can cause abdominal pain, vomiting, and diarrhea.
- Rare diagnoses:
- Congenital or acquired intestinal obstruction: Conditions such as pyloric stenosis or intestinal atresia, which are rare and usually present earlier in life.
- Endocrine disorders: Such as adrenal insufficiency, which can cause gastrointestinal symptoms among other systemic signs.
- Immunodeficiency: Certain immunodeficiencies can predispose to severe or recurrent gastrointestinal infections.