Make sure they take stool samples. They need to do a complete blood count test, I would ask them to include a panel on vitamin/mineral/electrolyte levels. It would be good for them to do a hormone check but you probably wont be able to get them to do that.
They could put him on a broad spectrum antibiotic, If it were me I'd ask them to do that. If it is indeed a bacterial infection you will typically see the person starting to get better within a day, maybe two, of an antibiotic.
The most worrysome thing you mention is his lethargy (wants to constantly sleep). That is not a good sign.
My DD had a horrid UTI that they misdiagnosed, and it moved into her kidneys at 2 yrs old, and had the same symptoms you describe. They kept telling me it was a virus..."there was this bad virus going around". After 4 pedi visits and about the 7th day, her lips started to get a subtle blue hue, her eyes slightly sunk in and had dark circles under them, and she started to hallucinate (was seeing monsters in her room). She wanted to sleep constantly, except for the 2 hours right after the tylenol was administered where she would get up and play.But as soon as it wore off she was back to her very sick self. The sleeping and blue lips, sunken eyes, all of that... are signs of going into shock. They finally tested her urine and It took 2 days before the antibiotics even kicked in, her infection was so bad. What They SHOULD have done was admited her and put her on an Ringers Lactate IV and an antibiotic IV. But they didnt , they only gave her 7 days of ABX pills.
Incapable morons!
Shock is so dangerous because it causes internal bleeding which damages tissues. in fact, ANY CHRONIC BACTERIAL INFECTION that is allowed to continue unabated will cause bleeding and damage to internal tissues. Some of the most susceptable areas to damage are the adrenal glands and then the thyroid, because these glands have a higher blood saturation than any other organ. The adrenal glands also share the tubules with the kidneys. So any infection the body is trying to detox and eliminate will be going through them.
Fast forward to now, my DD is 13 and has Addisons disease. That is where you adrenal gland doesnt put out enough hormones anymore because it has atrophied from tissue damage. A direct result of medical malpractice, for which my DD will never be the same again for the rest of her life. She has been close to death on a number of occasions. (the hormones from the gland control practically everything your body does, from your heart beat, to your blood pressure, your mood, stomache acid levels, glucose control, sleep patterns, breathing, colon muscles, metabolism, allergy and sickness progression, ...there is just too much to mention.)
So, I, like others, will implore you to get her back to an ER and you are going to have to come armed with some knowledge. It is much harder for them to sluff you off if you have some info under your belt. There is a website called Wrongdiagnosis.com.. this website helped me find out what was wrong with my DD. It took me 8 years of reasearch to FINALLY find out what she had, and that her sickness today was linked to her illness back then. I would have never suspected adrenal disease , but I found the answer, and I tell you the docs are still trying to tell me she is "normal". I know more about the human body than they do!
"Someone on here mentioned dehydration. This is also extremely important to be on top of. Directly because dehydration affects ELECTROLYTE LEVELS. Specifically, sodium, potassium, Phosphorus and a few others.
Sodium and potassium are held in check very tightly by the body, even a small imbalance is a major big deal, and will cause severe illness...again, will cause the body to go into shock. When my DD has an Addison crisis, the first thing I do is try to get electrolytes in her (gatorade)..because her adrenal gland isnt putting out the hormone that controls those electroylte levels. If she continues in a low sodium state, she will go into a coma.
So again go on to wrongdiagnosis.com. type in vomiting. Type in swollen abdomen. You may have to cross refrence many symptoms. I will pray for your wisdom, that the lord can deliver you through this.
Gail