Differentials
Viral gastroenteritis
SIGNS / SYMPTOMS
Usually insidious onset, accompanied by fever and other constitutional signs and symptoms. Self-limiting. Commonly caused by rotaviruses, noroviruses, and certain adenoviruses.
INVESTIGATIONS
Viral stool culture: positive for causative organism.
Bacterial gastroenteritis
SIGNS / SYMPTOMS
Usually accompanied by ingestion of spoiled food contaminated with Staphylococcus, Salmonella, Campylobacter, or other bacterial pathogens.
INVESTIGATIONS
Stool culture and culture of suspected food: positive for causative organism.
Acute myocardial infarction
SIGNS / SYMPTOMS
May be difficult to differentiate clinically.
History of coronary artery disease, presence of cardiac risk factors.
INVESTIGATIONS
ECG: ischemic changes.
Cardiac enzymes: elevated.
Epilepsy
SIGNS / SYMPTOMS
May have known history of seizures.
INVESTIGATIONS
electroencephalogram (EEG): epileptiform activity or focal, localizing abnormality.
Cyanide poisoning
SIGNS / SYMPTOMS
May be difficult to differentiate clinically (chronic cassava or prunus seed ingestion can cause cyanide toxicity). History of occupational exposure.
Cherry-red color to lips and skin may occur. May rarely smell bitter almonds on breath. Hypotension.
INVESTIGATIONS
ABG: acidosis, elevated lactate.
Acetaminophen poisoning
SIGNS / SYMPTOMS
History of deliberate overdose or chronic ingestion. May cause various degrees of liver injury including fulminant hepatic failure and hepatorenal syndrome.
INVESTIGATIONS
Serum acetaminophen levels: may be elevated.
Use of this content is subject to our disclaimer