Differential Diagnosis for Rash and Vomiting in Pediatrics
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is the most common cause of rash and vomiting in pediatric patients, often accompanied by diarrhea and fever. The rash can be a result of the viral infection itself or a secondary reaction.
Other Likely Diagnoses
- Food Allergy or Intolerance: An allergic reaction to food can cause vomiting, rash, and sometimes diarrhea. Common culprits include milk, eggs, peanuts, and shellfish.
- Urinary Tract Infection (UTI): While more common in females, UTIs can cause vomiting and a rash in pediatric patients, especially if the infection has spread to the kidneys.
- Viral Exanthems: Conditions like roseola, measles, and chickenpox can present with a rash and vomiting, often accompanied by fever and other systemic symptoms.
Do Not Miss Diagnoses
- Meningitis: Although less common, meningitis is a life-threatening condition that can present with vomiting, rash (in the case of meningococcal meningitis), and signs of meningeal irritation.
- Septicemia: Bacterial sepsis can cause a rash, vomiting, and severe systemic illness. Prompt recognition and treatment are crucial.
- Kawasaki Disease: An acute febrile illness that can cause rash, vomiting, and other systemic symptoms. If untreated, it can lead to serious cardiac complications.
Rare Diagnoses
- Stevens-Johnson Syndrome: A rare but serious condition usually triggered by medications or infections, characterized by a severe rash, blistering of the skin and mucous membranes, and systemic symptoms including vomiting.
- Toxic Epidermal Necrolysis (TEN): Similar to Stevens-Johnson Syndrome but more severe, often requiring intensive care for management.
- Erythema Multiforme: An immune-mediated condition that can cause a distinctive target-like rash and systemic symptoms, including vomiting, though it's less common in the context of vomiting compared to other symptoms.