What's your Medical Diagnosis? Newborn, vomiting, septic shock

The Isabel diagnosis tool touts an extensive database of conditions for differential diagnosis support, and we often will test its accuracy with real patient cases from the New England Journal of Medicine.

About the Isabel Diagnosis Challenge

The New England Journal of Medicine (NEJM) publishes interesting presentations of common diseases and unusual cases in the Clinical pathology Conference (CPC) series. These cases are educational and can pose diagnostic challenges even to the expert physicians at the Massachusetts General Hospital.

Using the clinical features of these cases you can evaluate your own diagnostic skills and compare your diagnostic performance to that of the physicians at MGH. If you are registered with Isabel as a client or have a free-trial subscription, you can use the diagnosis reminder system and run through some scenarios to get a list of likely suspects. Clicking on a diagnosis will take you through to various knowledge sources and links available from within Isabel.

Today's Case

#12:3 N Engl J Med. 366(4):361-372

Demographic: Male, Neonate, North America
Clinical features:

• bilious vomiting
• bloody diarrhea
• fever
• failure to pass meconium
• abdominal distention
• lethargy
• heme-positive stool
• septic shock

STOP !
Before you read further, construct your own: 1) Complete differential diagnosis and 2) Final diagnosis

Differential Diagnoses considered by the MGH panel: Volvulus Necrotising enterocolitis
Final Diagnosis of the case according to NEJM: Hirschsprung’s disease with enterocolitis
Differential Diagnoses of the case as given by the Isabel tool: Volvulus in Gastro, Necrotising enterocolitis in Infectious
Was the final diagnosis given by Isabel: Yes, Hirschsprung’s disease under large bowel obstruction in Gastro