Vomiting with Abdominal Pain and Fever

CLINICAL DIAGNOSTIC MANUAL

Vomiting accompanied by abdominal pain and fever are indicative of a possible infection or inflammation in various organs of the body. This clinical picture suggests an active immune response, which can be due to a variety of pathologies, from gastrointestinal infections to inflammatory processes or systemic infections. Rapid and accurate identification of the cause is essential, as some of these pathologies can progress quickly to serious complications if not treated promptly.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmation Diagnosis
Infectious gastroenteritis	Abdominal pain, vomiting, diarrhoea, fever, dehydration.	History of contact with contaminated food or water, sudden onset of gastrointestinal symptoms.	Stool culture identifying the pathogen.
Food poisoning	Nausea, vomiting, abdominal pain, moderate fever, symptoms within a few hours of consuming contaminated food.	History of recent intake of spoiled or suspected contaminated food.	Analysis of suspected food or more severe cases stool culture.
Urinary tract infection with pyelonefritis	Pain in the flank or lower abdomen, high fever, nausea, vomiting, chills, dysuria.	High fever with flank pain and urinary symptoms, history of recurrent urinary infections.	Positive urine culture, urine analysis showing pyuria and bacteriuria.
Acute appendicitis	Pain in lower right quadrant, nausea, vomiting, fever, pain on palpation in the right iliac fossa.	Pain migrating to the lower right quadrant with peritoneal signs on physical examination (positive rebound).	Abdominal ultrasound or CT showing signs of appendix inflammation.
Mesenteric adenitis	Diffuse abdominal pain, fever, vomiting, symptoms similar to appendicitis, often in children.	Abdominal pain mimicking appendicitis, but with milder symptoms and no clear signs of peritonitis.	Abdominal ultrasound or CT showing inflamed mesenteric lymph nodes.
Non-specific abdominal pain	Diffuse abdominal pain, mild fever, nausea, vomiting, without a clear apparent cause.	Diagnosis of exclusion when other causes are not identified.	Laboratory tests and imaging studies with no specific findings.
Toxic shock syndrome	High fever, vomiting, diarrhoea, abdominal pain, signs of hypotension, rash, progressive multi-organ failure.	High fever with gastrointestinal symptoms and rapid progression to hypotension and shock signs.	Blood culture positive for Staphylococcus or Streptococcus.
Lobar pneumonia	Referred abdominal pain (in cases involving lower lobes), fever, cough, dyspnoea.	Fever and respiratory symptoms with abdominal pain instead of thoracic pain.	Chest X-ray or CT showing consolidation in the lower lobe.
Pelvic inflammatory disease	Lower abdominal pain, fever, abnormal vaginal discharge, nausea, vomiting, pain during sexual intercourse.	Pelvic pain with fever and history of sexually transmitted infections or use of intrauterine devices.	Transvaginal ultrasound with signs of pelvic inflammation. Vaginal culture positive.
Haemolytic uraemic syndrome	Abdominal pain, fever, bloody diarrhoea, nausea, vomiting, renal failure.	History of E. coli (O157:H7) infection with gastrointestinal symptoms and progression to renal failure.	Altered renal function tests (urea, creatinine). Blood count with microangiopathic haemolytic anaemia. Positive E. coli culture.
Malaria	Intermittent fever, vomiting, abdominal pain, chills, sweating, headache, systemic symptoms in advanced stages.	Recent travel history to malaria-endemic areas, cyclical fever with gastrointestinal symptoms.	Blood smear or rapid malaria test positive for Plasmodium spp.