Updated 11 August 2015

What's your diagnosis? – Case 22: vomiting and headaches

Mrs B became very concerned when her 15-year-old son started vomiting profusely and complaining about headaches. Take out your textbooks and see if you can solve this week's case.


Mrs B's 15-year-old son, Boy X, is a healthy grade 9 learner. Two days ago he started complaining about not feeling well. At first she wasn't too concerned, thinking that the boy was just tired from school and sport every afternoon.

When he developed a persistent fever of more than 39 degrees, Mrs B became more worried. Boy X also complained of headache, earache and joint pains. The headaches became progressively worse with lethargy and "neck pain". While taking his temperature, she noticed small bruise-like marks covering his upper body and arms. She asked her son what this was and he said it might have been caused by tackling during rugby practice.

Mrs B gave Boy X fever medication and tucked him into bed.

The next morning she became really concerned when she found Boy X drenched in sweat, very irritable, vomiting profusely and speaking unintelligibly. He also did not want her to put on the bedroom light.   

Not knowing what was wrong with her son, Mrs B took him to the doctor. 

Given the above information, what is the most likely diagnosis? What will the doctor most likely find on examination? What would the management of his condition entail?

What's your diagnosis? Join the guesswork on our Facebook page, or comment below.

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays. We'll post the answer with the story on Mondays, or you can get it via the Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? -  Case 1: vomiting and weight loss

What's your diagnosis? -  Case 2: eye pain

What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis? -  Case 4: seeing odd things

What's your diagnosis? - Case 5: mysterious lungs

What's your diagnosis? - Case 6: runner with seizures

What's your diagnosis? - Case 7: swollen knee

What's your diagnosis? - Case 8: bloody semen

What's your diagnosis? - Case 9: confusing neurological signs

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis? - Case 11: bruising with no apparent reason

What's your diagnosis? - Case 12: severe tummy pain

What's your diagnosis? - Case 13: severe sore throat

What's your diagnosis? - Case 14: abdominal pain and swelling

What's your diagnosis? - Case 15: the world is spinning

What's your diagnosis? - Case 16: numbness in forearm

What's your diagnosis? - Case 17: burning urine

What's your diagnosis? - Case 18: boy with persistent fever

What's your diagnosis? – Case 19: lady who can't lose weight

What's your diagnosis? – Case 20: chest pain next to breastbone

What's your diagnosis? – Case 21: burning sensation in vagina

Image: Boy with headache from Shutterstock

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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