Differential Diagnosis for Abdominal Pain, Headaches, Fever, and Laboratory Abnormalities in a 7-Year-Old
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of elevated leukocytes in urine strongly suggests a UTI, which can cause abdominal pain, fever, and headaches. The elevated serum protein, platelets, monocytes, and eosinophils can be secondary responses to the infection.
Other Likely Diagnoses
- Acute Pyelonephritis: This is a type of kidney infection that can cause similar symptoms to a UTI, including abdominal pain, fever, and headaches. The laboratory findings, such as elevated leukocytes in urine and elevated platelets, are consistent with this diagnosis.
- Viral Gastroenteritis: Although the primary symptoms are abdominal pain and fever, viral gastroenteritis can also cause headaches. The elevated monocytes and eosinophils can be seen in viral infections.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with abdominal pain, fever, and headaches. The elevated platelets, monocytes, and eosinophils can be associated with the inflammatory process.
Do Not Miss Diagnoses
- Appendicitis: Although the symptoms can be non-specific, appendicitis is a surgical emergency that requires prompt diagnosis. The abdominal pain, fever, and elevated leukocytes could be indicative of appendicitis.
- Sepsis: Any infection that causes a systemic inflammatory response can lead to sepsis, a life-threatening condition. The combination of fever, elevated leukocytes, and elevated platelets should raise suspicion for sepsis.
- Kidney Stones: While less common in children, kidney stones can cause severe abdominal pain, fever, and headaches. The elevated leukocytes in urine could be misinterpreted as a UTI, but the presence of stones would require different management.
Rare Diagnoses
- Hemolytic Uremic Syndrome (HUS): This condition, often associated with E. coli infections, can cause abdominal pain, fever, and kidney failure. The elevated platelets and eosinophils could be seen in HUS.
- Systemic Lupus Erythematosus (SLE): Although rare in children, SLE can present with a wide range of symptoms, including abdominal pain, fever, and headaches. The elevated serum protein and eosinophils could be associated with SLE.
- Lymphoma: Certain types of lymphoma can cause systemic symptoms like fever, headaches, and abdominal pain. The elevated monocytes and eosinophils could be seen in lymphoma, although this would be an uncommon presentation in a child.