Crying infant

Differential Diagnosis

Crying Infant

• Occult infection
  • Sepsis
  • Meningitis
  • UTI
  • Otitis media
  • Pneumonia
• GI
  • Intussusception
  • GERD
  • Incarcerated hernia
  • Milk protein intolerance
  • Anal fissure
• Ophtho
  • Corneal abrasion
• Occult trauma
  • Hair tourniquet (on extremities, penis)
  • Non-accidental trauma
  • Diaper pin
  • Insect bites
  • Burns in mouth
• Misc
  • Colic
  • Scorpion envenomation
  • SVT
  • Testicular torsion
  • Drug exposure/overdose (commonly methamphetamine or cocaine)
  • Neonatal abstinence syndrome, drug withdrawal

Work-Up

1. rule out badness above including shaken baby
2. flourescein staining to r/o corneal abrasions
3. fundoscopic exam
4. r/o otitis
5. examine all bones/joints to r/o fx, osteo or septic joint
6. inspect GU area
7. Skeletal survey & head CT in suspected child abuse
8. 4% benefit from change to soy formula
9. rocking, warm compresses to belly feeding, frequent burping, diaper changes

Source

C. 243 Harwood