Differential Diagnosis for Norovirus and Vomiting with Neurological Symptoms
Single Most Likely Diagnosis
- Viral Encephalitis: This is the most likely diagnosis given the symptoms of brain inflammation and mass on the CT scan, following a viral gastrointestinal infection like norovirus. The progression from gastrointestinal symptoms to neurological symptoms such as blurry vision and the findings on the CT scan support this diagnosis.
Other Likely Diagnoses
- Cerebral Edema: Dehydration from prolonged vomiting can lead to cerebral edema, which could explain the neurological symptoms and the mass effect seen on the CT scan.
- Hyponatremic Encephalopathy: Severe vomiting can lead to hyponatremia, which in turn can cause brain swelling and neurological symptoms, including blurry vision.
- Status Epilepticus: Although less directly related to the initial symptoms, status epilepticus could result from various causes including infections and could present with altered mental status and neurological deficits.
Do Not Miss Diagnoses
- Brain Abscess: Although less common, a brain abscess could present with similar symptoms, including fever, vomiting, and neurological deficits. It is crucial to consider this diagnosis due to its severe consequences if left untreated.
- Subarachnoid Hemorrhage: This condition, often presenting with sudden onset of severe headache, could also lead to vomiting and neurological symptoms. It's a critical diagnosis not to miss due to its high mortality rate.
- Meningitis: Bacterial or viral meningitis could present with similar symptoms, including fever, vomiting, headache, and neurological symptoms. Given the potential for severe outcomes, it's essential to consider and rule out meningitis.
Rare Diagnoses
- Reye's Syndrome: A rare but serious condition that causes swelling in the liver and brain, often associated with viral infections and aspirin use in children. It presents with vomiting, confusion, and neurological symptoms.
- Acute Disseminated Encephalomyelitis (ADEM): A rare autoimmune disease triggered by a viral infection, leading to brain inflammation and symptoms such as vision loss, weakness, and impaired consciousness.
- Cerebral Vasculitis: Inflammation of the blood vessels in the brain, which could be secondary to an infection or an autoimmune process, presenting with a wide range of neurological symptoms.