Differential Diagnosis for a 2-year-old with 32,000 WBC
- Single most likely diagnosis:
- Viral infection (e.g., upper respiratory tract infection): This is the most common cause of elevated white blood cell count in a child of this age, often presenting with symptoms such as fever, cough, and runny nose.
- Other Likely diagnoses:
- Bacterial infection (e.g., pneumonia, urinary tract infection): These infections can also cause an elevated WBC count and are common in this age group, often presenting with symptoms such as fever, cough, and difficulty urinating.
- Acute otitis media: A common condition in young children that can cause an elevated WBC count, often presenting with ear pain, fever, and irritability.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Bacteremia or sepsis: Although less common, these conditions are life-threatening and require immediate attention, often presenting with symptoms such as high fever, lethargy, and poor perfusion.
- Meningitis: A serious and potentially life-threatening condition that can cause an elevated WBC count, often presenting with symptoms such as fever, headache, and stiff neck.
- Appendicitis: Although rare in this age group, appendicitis can cause an elevated WBC count and is a surgical emergency, often presenting with symptoms such as abdominal pain, fever, and vomiting.
- Rare diagnoses:
- Leukemia: A rare but serious condition that can cause an elevated WBC count, often presenting with symptoms such as fatigue, weight loss, and bruising.
- Juvenile idiopathic arthritis: A chronic condition that can cause an elevated WBC count, often presenting with symptoms such as joint pain, swelling, and fever.
- Immune-mediated disorders (e.g., Kawasaki disease): Rare conditions that can cause an elevated WBC count, often presenting with symptoms such as fever, rash, and lymphadenopathy.