Differential Diagnosis for Recurrent Vomiting with a High White Blood Count
Single Most Likely Diagnosis
- Gastroenteritis: This is often the most common cause of recurrent vomiting and can be accompanied by an elevated white blood cell count, indicating an infectious or inflammatory process. The high white blood cell count can be seen in bacterial gastroenteritis.
Other Likely Diagnoses
- Appendicitis: Although more commonly associated with abdominal pain, appendicitis can cause vomiting and is accompanied by an elevated white blood cell count due to the inflammatory response.
- Cholecystitis: Inflammation of the gallbladder can cause vomiting and an elevated white blood cell count, especially if the cause is infectious.
- Pancreatitis: Both acute and chronic pancreatitis can present with vomiting and an elevated white blood cell count, indicating inflammation of the pancreas.
- Food Poisoning: Certain types of food poisoning, especially those caused by bacteria like Salmonella or E. coli, can lead to vomiting and an elevated white blood cell count.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause bowel obstruction and ischemia. It's a surgical emergency and can present with vomiting and an elevated white blood cell count.
- Volvolus or Bowel Obstruction: These conditions can cause severe vomiting and may have an elevated white blood cell count if there's associated ischemia or infection.
- Perforated Viscus: A hole in the wall of the stomach or intestine can lead to peritonitis, characterized by severe abdominal pain, vomiting, and a high white blood cell count.
- Septicemia: Bacteremia can cause a systemic inflammatory response, including vomiting and a significantly elevated white blood cell count.
Rare Diagnoses
- Neurological Conditions: Certain neurological conditions, such as increased intracranial pressure or brain tumors, can cause vomiting and may have a secondary elevation in white blood cell count due to stress response.
- Adrenal Insufficiency: Although rare, adrenal insufficiency can cause vomiting and may have an elevated white blood cell count, especially during an acute crisis.
- Hematological Malignancies: Leukemias or lymphomas can cause a high white blood cell count and may lead to vomiting due to various mechanisms, including metabolic disturbances or direct involvement of the gastrointestinal tract.