Differential Diagnosis for a 15-month-old with Diarrhea and Possible UTI Symptoms
- Single most likely diagnosis:
- Viral gastroenteritis: This is the most likely diagnosis given the symptoms of diarrhea, low-grade fevers, and the age of the patient. The fever resolution and ongoing diarrhea are consistent with a viral etiology.
- Other Likely diagnoses:
- Urinary Tract Infection (UTI): Although less common in this age group without other risk factors, the mother's concern about the child touching her diaper area and the report of decreased wet diapers could suggest a UTI. However, the absence of high fever, dysuria, or other specific urinary symptoms makes it less likely.
- Dehydration: Given the history of diarrhea and decreased wet diapers, dehydration is a significant concern and should be evaluated and managed promptly.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Bacterial gastroenteritis (e.g., E. coli, Salmonella): Although less common than viral causes, bacterial gastroenteritis can lead to severe complications, including hemolytic uremic syndrome (HUS), especially in young children.
- Intussusception: This condition, where a part of the intestine slides into an adjacent part, can cause abdominal pain, vomiting, and bloody stools. It's a medical emergency and can be a complication of viral gastroenteritis.
- Sepsis: Any infection, including UTI or gastroenteritis, can lead to sepsis, a life-threatening condition that requires immediate recognition and treatment.
- Rare diagnoses:
- Inflammatory bowel disease (IBD): Although rare in this age group, IBD (Crohn's disease or ulcerative colitis) can present with chronic diarrhea, abdominal pain, and fever.
- Food poisoning: Certain types of food poisoning can cause severe gastrointestinal symptoms, but this would typically be associated with a clear history of ingestion of contaminated food.