Differential Diagnosis for a 2-year-old child with fever, decreased oral intake, and uprolling of eyes

• Single most likely diagnosis
  • Febrile seizure: This is a common condition in children of this age group, characterized by seizures accompanied by fever, which can cause uprolling of the eyes. Decreased oral intake can be a result of the underlying infection causing the fever.
• Other Likely diagnoses
  • Meningitis: This is an infection of the protective membranes covering the brain and spinal cord, known as the meninges. Symptoms can include fever, decreased oral intake, and signs of neurological irritation such as uprolling of the eyes.
  • Encephalitis: An inflammation of the brain tissue, most often caused by viral infections. Symptoms can include fever, altered mental status, and seizures, which might manifest as uprolling of the eyes.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Status epilepticus: A life-threatening condition where the brain is in a state of persistent seizure that lasts longer than five minutes or when a person has recurrent seizures without regaining full consciousness between seizures. Uprolling of the eyes could be a sign of ongoing seizure activity.
  • Brain abscess: A rare but potentially life-threatening condition where a pocket of pus forms in the brain. Symptoms can include fever, headache, and neurological deficits, which might include abnormal eye movements.
• Rare diagnoses
  • Subarachnoid hemorrhage: Although rare in children, it can present with sudden onset of fever (if due to an infectious cause), decreased oral intake due to altered mental status, and uprolling of the eyes due to increased intracranial pressure.
  • Metabolic disorders: Certain metabolic disorders can present with seizures, altered mental status, and other neurological symptoms, including uprolling of the eyes, especially during episodes of metabolic decompensation.