Differential Diagnosis for Diarrhea and Swelling of Scrotum in a 2-Year-Old
Single Most Likely Diagnosis
- Henoch-Schönlein Purpura (HSP): This condition is a form of vasculitis that can cause a range of symptoms including gastrointestinal issues like diarrhea, and it can also lead to scrotal swelling due to inflammation. It's a common condition in children and fits the described symptoms.
Other Likely Diagnoses
- Inguinal Hernia: An inguinal hernia can cause swelling in the scrotum and, if it becomes incarcerated, can lead to bowel obstruction, which might result in diarrhea. This is a plausible cause given the age and symptoms.
- Orchitis or Epididymitis: Inflammation of the testicles or epididymis can cause scrotal swelling and might be accompanied by systemic symptoms like diarrhea, especially if there's an underlying infection.
- Urinary Tract Infection (UTI): While less common in boys, a UTI could potentially cause both diarrhea (due to the infection itself or associated gastrointestinal upset) and scrotal swelling if the infection spreads or causes significant local inflammation.
Do Not Miss Diagnoses
- Testicular Torsion: Although this condition typically presents with acute, severe pain and swelling of the scrotum, it's an emergency that requires immediate attention. Diarrhea might not be a direct symptom, but it could be present if the child has a concurrent gastrointestinal issue. Missing this diagnosis could result in loss of the testicle.
- Appendicitis: While appendicitis primarily causes abdominal pain, in some cases, especially if the appendix is retrocecal, it might cause pain or swelling that could be referred to the scrotum. Diarrhea could be a symptom if the appendix is near the intestines and causes an ileus or obstruction.
Rare Diagnoses
- Lymphoma or Other Malignancies: Certain cancers could cause both gastrointestinal symptoms like diarrhea and scrotal swelling due to metastasis or local tumor growth. These are rare in children but must be considered in the differential diagnosis to ensure timely and appropriate treatment.
- Tuberculosis: TB can affect various parts of the body, including the gastrointestinal tract and the genitourinary system, potentially causing the described symptoms. However, it's less common in young children without known exposure or immunocompromised status.