Differential Diagnosis for Vomiting with Elevated WBC, Eosinophils, Neutrophils, and Monocytes
- Single Most Likely Diagnosis
- Gastroenteritis: This condition is characterized by inflammation of the gastrointestinal tract, often caused by viral or bacterial infections. The elevated WBC count with increases in eosinophils, neutrophils, and monocytes can be seen in response to the infection. Vomiting is a common symptom of gastroenteritis.
- Other Likely Diagnoses
- Food poisoning: Similar to gastroenteritis, food poisoning can cause vomiting and an elevated WBC count with a mix of eosinophils, neutrophils, and monocytes due to the body's response to the ingested toxin or pathogen.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with vomiting, especially if there is significant involvement of the upper GI tract. The elevated WBC count with various cell types can reflect the chronic inflammation seen in IBD.
- Parasitic infection: Certain parasitic infections, such as giardiasis, can cause gastrointestinal symptoms including vomiting. The presence of eosinophilia can be a clue to a parasitic infection.
- Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with abdominal pain, vomiting can be a symptom, especially in children or if the appendix is located in an atypical position. The elevated WBC count with neutrophilia is common in appendicitis. Missing this diagnosis can lead to severe consequences, including perforation and peritonitis.
- Intussusception: This condition, where a part of the intestine telescopes into another, can cause vomiting and is a medical emergency. It often presents with abdominal pain and can have an elevated WBC count. Intussusception requires prompt diagnosis and treatment to prevent complications.
- Rare Diagnoses
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause vomiting among other symptoms. The marked eosinophilia can be a distinguishing feature.
- Whipple's disease: A rare, systemic bacterial infection that can cause malabsorption, weight loss, and gastrointestinal symptoms, including vomiting. The diagnosis is often suggested by the presence of periodic acid-Schiff (PAS)-positive material in macrophages in the intestinal mucosa.