Differential Diagnosis for Bloody, Non-Mucus Diarrhea in a Child
Single Most Likely Diagnosis
- Infectious gastroenteritis: This is the most common cause of bloody diarrhea in children, often due to bacterial infections such as Shiga toxin-producing E. coli (STEC), Salmonella, or Shigella. The presence of blood without mucus suggests an invasive bacterial infection.
Other Likely Diagnoses
- Intussusception: Although more commonly associated with abdominal pain and currant jelly stool (blood and mucus), intussusception can occasionally present with bloody, non-mucus diarrhea, especially if the intussusception is not complete.
- Food poisoning: Certain types of food poisoning, such as that caused by Salmonella or Campylobacter, can lead to bloody diarrhea.
- Inflammatory bowel disease (IBD): Conditions like ulcerative colitis or Crohn's disease can cause chronic bloody diarrhea, although they are less common in young children.
Do Not Miss Diagnoses
- Hemolytic uremic syndrome (HUS): A complication of STEC infection, HUS can lead to renal failure and is a medical emergency. Early recognition is crucial.
- Intestinal ischemia: Although rare, intestinal ischemia due to conditions like midgut volvulus or superior mesenteric artery thrombosis can cause bloody diarrhea and is a surgical emergency.
- Meckel's diverticulum: A congenital anomaly that can cause painless, bloody diarrhea due to the presence of ectopic gastric mucosa.
Rare Diagnoses
- Allergic colitis: More commonly seen in infants, allergic colitis can cause bloody stools, but it is less likely in older children.
- Vasculitis: Conditions like Henoch-Schönlein purpura can cause gastrointestinal symptoms, including bloody diarrhea, but are relatively rare.
- Gastrointestinal lymphoma or other malignancies: Although extremely rare in children, these conditions can cause bloody diarrhea and should be considered in the differential diagnosis if other causes have been ruled out.