Differential Diagnosis for Vomiting in a 6-year-old

Single Most Likely Diagnosis

• Viral Gastroenteritis: This is the most common cause of vomiting in children, often accompanied by diarrhea, fever, and abdominal cramps. The high incidence and contagious nature of viral gastroenteritis make it a leading consideration.

Other Likely Diagnoses

• Food Poisoning: Consuming contaminated or spoiled food can lead to vomiting, diarrhea, and stomach cramps. The symptoms can start within hours of eating the contaminated food.
• Urinary Tract Infection (UTI): While more common in girls, UTIs can cause vomiting, fever, and abdominal pain in children.
• Appendicitis: Although less common in this age group, appendicitis can present with vomiting, abdominal pain (initially diffuse, then localized to the right lower quadrant), and fever.
• Gastroesophageal Reflux Disease (GERD): Can cause vomiting, especially after eating, and is often associated with heartburn and regurgitation.

Do Not Miss Diagnoses

• Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood flow. It's a medical emergency that can cause vomiting, abdominal pain, and bloody stools.
• Pyloric Stenosis: More common in infants but can occur in older children, causing projectile vomiting due to narrowing of the pylorus, the passage between the stomach and small intestine.
• Diabetic Ketoacidosis (DKA): A serious complication of diabetes that can cause vomiting, dehydration, and altered mental status. It's crucial to consider in children with known or undiagnosed diabetes.
• Meningitis: An infection of the membranes surrounding the brain and spinal cord, which can cause vomiting, fever, headache, and stiff neck.

Rare Diagnoses

• Cyclic Vomiting Syndrome: A condition characterized by recurrent episodes of severe vomiting lasting hours to days, with periods of normal health in between.
• Inborn Errors of Metabolism: Certain genetic disorders can lead to episodes of vomiting, often accompanied by other systemic symptoms, due to the body's inability to properly metabolize nutrients.
• Brain Tumors: Although rare, brain tumors can cause vomiting, especially in the morning, due to increased intracranial pressure.
• Foreign Body Ingestion: Swallowing non-food items can sometimes cause vomiting, especially if the object obstructs the gastrointestinal tract.