John is admitted at 8 months

John is admitted aged eight months with a 2-day history of not being himself and has vomited on one occasion.

What differential diagnosis should you consider specifically in a child with spina bifida?

Exemplar

  • Urinary tract infection (UTI)

  • Shunt problems

  • Fractures – can be painless

  • Any new medication

  • Common childhood illnesses