Differential Diagnosis for 14-month-old Female
Single Most Likely Diagnosis
- Viral infection: The elevated WBC count with a predominance of neutrophils (seg neut absolute 12.9) and the presence of monocytes (monocytes abs 1.5) suggests an infectious process, likely viral given the age and presentation. The hemoglobin level is slightly low, which could be seen in chronic or acute infections.
Other Likely Diagnoses
- Bacterial infection: Although the presentation could suggest a viral etiology, bacterial infections cannot be ruled out without further testing. The elevated WBC count and the differential could also be consistent with a bacterial infection, especially if the patient is showing signs of infection such as fever or localized signs of infection.
- Anemia of chronic disease: The slightly low hemoglobin (10.1) could be indicative of anemia of chronic disease, which can be seen in chronic infections, autoimmune diseases, or other chronic conditions. However, without more specific markers or a longer history, this remains speculative.
Do Not Miss Diagnoses
- Sepsis: Although the patient's lab values do not immediately suggest sepsis (e.g., no significant leukocytosis with a left shift, no mention of hypotension or organ dysfunction), sepsis can present subtly in young children. It is crucial to consider sepsis in any child with a fever or signs of infection, as it can rapidly progress to a life-threatening condition.
- Meningitis: Given the age of the patient and the potential for infection, meningitis must be considered, especially if there are any signs of neurological impairment or fever without a clear source.
- Leukemia: Although less likely given the clinical context, leukemia can present with anemia, leukocytosis, and thrombocytopenia. It is a diagnosis that would have a significant impact on management and prognosis, making it essential not to miss.
Rare Diagnoses
- Congenital or acquired immunodeficiency: Conditions affecting the immune system could lead to recurrent or severe infections. While rare, these diagnoses are important to consider, especially if the patient has a history of recurrent infections or fails to respond to appropriate treatment.
- Bone marrow failure syndromes: These are rare conditions that affect the production of blood cells. They could potentially explain the anemia and changes in the WBC count, although other signs such as thrombocytopenia would typically be present.