What is the likely diagnosis for a 3-year-old male patient, Sebastian, presenting with diarrhea, abdominal pain, and a history of lactose intolerance, who has been experiencing symptoms similar to his family members and a support worker with gastroenteritis?

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Differential Diagnosis for Sebastian

  • Single most likely diagnosis
    • Viral Gastroenteritis: This is the most likely diagnosis given the symptoms of diarrhea, abdominal pain, and the presence of similar symptoms in the family members, suggesting a contagious cause. The fact that a support worker with gastroenteritis may have transmitted the illness to the family further supports this diagnosis.
  • Other Likely diagnoses
    • Bacterial Gastroenteritis: Although less likely than viral gastroenteritis, bacterial causes such as Salmonella, Shigella, or Campylobacter could be considered, especially if the symptoms are severe or if there's a history of consuming undercooked food or contaminated water.
    • Food Poisoning: Given Sebastian's lactose intolerance and the use of soy milk, it's less likely, but if there was an issue with the soy milk or other food items, it could be a consideration.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Intussusception: Although rare, intussusception is a condition where a part of the intestine slides into an adjacent part, potentially causing bowel obstruction. It's a medical emergency and can present with abdominal pain and diarrhea.
    • Appendicitis: While less common in toddlers, appendicitis can present with abdominal pain and diarrhea. It's crucial to consider this diagnosis to avoid missing a surgical emergency.
    • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis are less common in young children but can present with chronic diarrhea and abdominal pain.
  • Rare diagnoses
    • Toddler's Diarrhea: A condition characterized by chronic, non-bloody diarrhea in toddlers, often without other symptoms. It's a diagnosis of exclusion.
    • Giardiasis: An intestinal infection caused by the Giardia parasite, which can lead to diarrhea and abdominal pain. It's less common but should be considered, especially if there's a history of exposure to contaminated water.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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