Differential Diagnosis for a 3-year-old child with fever, abdominal pain, and foamy pink vomiting
- Single most likely diagnosis
- Acute gastroenteritis: This is a common condition in children, often caused by viral infections, and can be exacerbated by the ingestion of something from a purse, potentially contaminated or toxic.
- Other Likely diagnoses
- Ingestion of a toxic substance (e.g., medications, household cleaners): Given the history of possibly ingesting something from a purse, this is a plausible cause for the symptoms, as many substances can cause gastrointestinal irritation, fever, and vomiting.
- Food poisoning: If the child ingested spoiled or contaminated food, this could lead to similar symptoms.
- Appendicitis: Although less common in very young children, appendicitis can present with abdominal pain, fever, and vomiting.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intussusception: A condition where a part of the intestine slides into another, which can cause severe abdominal pain, vomiting, and fever. It's a medical emergency.
- Volvulus: A twisting of the intestine that can cut off blood flow, leading to severe abdominal pain, vomiting, and fever.
- Ingestion of a caustic substance: Substances like bleach can cause severe burns to the esophagus and stomach, leading to vomiting, abdominal pain, and potentially life-threatening complications.
- Botulism: If the child ingested something contaminated with botulinum toxin (e.g., from improperly canned goods), this could lead to severe and potentially life-threatening symptoms.
- Rare diagnoses
- Pyloric stenosis: A condition where the pylorus (the passage between the stomach and small intestine) thickens, blocking food from entering the small intestine, leading to vomiting.
- Hemolytic uremic syndrome (HUS): A condition that can occur after certain bacterial infections (like E. coli), leading to kidney failure and other severe symptoms.
- Kawasaki disease: An autoimmune condition that can cause fever, abdominal pain, and vomiting, among other symptoms, although it's more commonly associated with rash, conjunctivitis, and lymphadenopathy.