Differential Diagnosis for 76 year old female with fever, chills, night sweats, and bilateral temporal headache
- Single most likely diagnosis
- Temporal arteritis (Giant Cell Arteritis): The patient's symptoms of bilateral temporal headache, fever, and night sweats, especially in the context of her age, are highly suggestive of temporal arteritis. The presence of a mild fever and systemic symptoms further supports this diagnosis.
- Other Likely diagnoses
- Bacterial meningitis: Although the urinalysis shows no leukocytes, the presence of fever, chills, and headache could still indicate bacterial meningitis, especially if the patient has a compromised immune system or other underlying conditions.
- Sinusitis: The patient's symptoms of headache and fever could be indicative of sinusitis, particularly if the headache is localized to the temporal region and is accompanied by facial pain or pressure.
- Osteomyelitis or dental infection: Infection in the bones of the face or a dental infection could cause localized pain and fever, although these would typically be accompanied by more localized signs of infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although the patient's symptoms do not strongly suggest a subarachnoid hemorrhage, this condition can present with sudden onset of headache and should always be considered in the differential diagnosis of headache, especially in older adults.
- Endocarditis: The patient's fever and systemic symptoms could be indicative of endocarditis, particularly if she has a history of heart disease or other risk factors.
- Sepsis: The presence of fever, chills, and night sweats, even without a clear source of infection, should prompt consideration of sepsis, especially in an older adult.
- Rare diagnoses
- CNS vasculitis: This is a rare condition that could present with headache, fever, and systemic symptoms, although it would typically be accompanied by other neurological signs and symptoms.
- Trigeminal neuralgia: Although this condition typically presents with sudden, severe facial pain, it could be considered in the differential diagnosis of headache, especially if the pain is localized to one side of the face.
- Hypertensive emergency: A sudden onset of severe headache could be indicative of a hypertensive emergency, although this would typically be accompanied by significantly elevated blood pressure.