Differential Diagnosis for a 16-month-old girl with suspected drain cleaner ingestion
- Single most likely diagnosis:
- Esophageal strictures (B): The patient's symptoms of excessive drooling and burns on her lips and tongue suggest ingestion of a caustic substance, which is consistent with the open bottle of drain cleaner found at the scene. Esophageal strictures are a well-known complication of caustic ingestions, particularly with alkaline substances like drain cleaner.
- Other Likely diagnoses:
- Pneumonitis (D): Aspiration of the caustic substance can lead to chemical pneumonitis, which is a likely complication given the patient's symptoms.
- Cardiac arrhythmias (A): Ingestion of certain substances can affect cardiac function, although this is less directly related to the caustic nature of drain cleaner, it could be a consequence of the systemic response to the injury.
- Do Not Miss diagnoses:
- Renal failure (E): Although less common, severe caustic ingestions can lead to systemic complications including renal failure, especially if there's significant tissue damage or if the patient experiences hypovolemia or shock.
- Hepatic failure (C): Similar to renal failure, hepatic failure is a potential systemic complication of severe caustic ingestions, though it is less directly related to the primary injury from drain cleaner.
- Rare diagnoses:
- Other rare complications could include gastric perforation, tracheoesophageal fistula, or long-term respiratory issues, but these are less likely and more specific to the extent and nature of the caustic injury.