Differential Diagnosis for 76-year-old Female with Fever and Leg Cramps
- Single most likely diagnosis
- Urinary Tract Infection (UTI): The patient's concern about UTI is valid, given her symptoms of fever and the fact that UTIs are common in elderly females. The absence of typical urinary symptoms like dysuria or frequency does not rule out UTI, especially in the elderly, who may present atypically.
- Other Likely diagnoses
- Viral illness: Despite the denial of cough, sore throat, or sinus congestion, a viral illness could still be present, especially given the non-specific symptoms of fever, headache, and night sweats.
- Bacterial sepsis: Elderly individuals can present with non-specific symptoms, and bacterial sepsis should be considered, especially with fever and potential for an occult source of infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis from an abdominal source (e.g., diverticulitis, cholecystitis): These conditions can present subtly in the elderly and are life-threatening if not promptly diagnosed and treated.
- Endocarditis: Although less common, infective endocarditis can present with fever, night sweats, and non-specific symptoms, and is critical to diagnose early due to its high mortality rate if untreated.
- Meningitis: While the patient denies headache, which is a common symptom of meningitis, the presence of fever and potential for altered mental status (not explicitly mentioned but possible in the elderly) makes this a diagnosis that cannot be missed.
- Rare diagnoses
- Lymphoma: Night sweats are a classic symptom of lymphoma, although this diagnosis would be less likely without other supporting symptoms like significant weight loss or lymphadenopathy.
- Tuberculosis (TB): Although rare, TB can present with non-specific symptoms like fever, night sweats, and weight loss, and should be considered, especially if the patient has risk factors for TB exposure.