Differential Diagnosis for Not Waking Up and White Pus Near Lips

• Single Most Likely Diagnosis
  • Pneumonia or other severe respiratory infection: The presence of white pus near the lips could indicate aspiration or an oral infection, and not waking up suggests a severe systemic infection affecting the central nervous system or a severe respiratory condition leading to hypoxia.
• Other Likely Diagnoses
  • Sepsis: A systemic infection that could lead to altered mental status and the presence of pus could be a sign of a localized infection that has spread systemically.
  • Meningitis: An infection of the meninges that could cause altered mental status, including not waking up, and could potentially lead to oral infections or pus formation if the causative agent is bacterial and has spread.
  • Stroke or Intracranial Hemorrhage: Although not directly related to white pus, these conditions can cause sudden alterations in mental status, including not waking up, and require immediate medical attention.
• Do Not Miss Diagnoses
  • Epiglottitis: A severe and potentially life-threatening condition that can cause airway obstruction and altered mental status due to hypoxia. The presence of pus near the lips could be related to an oral or pharyngeal infection.
  • Tetanus: Although rare, tetanus infection can cause severe muscle rigidity and spasms, potentially leading to an inability to wake up due to respiratory failure, and can present with oral or facial spasms.
• Rare Diagnoses
  • Rabies: A viral infection that can cause altered mental status, including aggression and confusion, progressing to paralysis and coma. The presence of white pus near the lips could be related to the bite wound if the infection was transmitted through an animal bite.
  • Brain Abscess: A rare condition where an abscess forms in the brain, potentially causing altered mental status, including not waking up, and could be related to a systemic infection or direct spread from an adjacent structure like the sinuses or ears.