Differential Diagnosis for a 16-year-old Female with GERD, Sore Throat, Cough, Congestion, and Intractable Vomiting
- Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD) exacerbation: The patient's history of GERD and symptoms of intractable vomiting suggest that her condition may have worsened, leading to increased reflux and subsequent vomiting.
- Other Likely Diagnoses
- Viral gastroenteritis: Although the patient's initial symptoms of sore throat, cough, and congestion improved, the onset of intractable vomiting could be indicative of a viral gastrointestinal infection.
- Gastritis: Inflammation of the stomach lining could be causing the patient's vomiting, especially if she has a history of GERD or has been taking nonsteroidal anti-inflammatory drugs (NSAIDs).
- Peptic ulcer disease: A peptic ulcer could be causing the patient's vomiting, especially if she has a history of GERD or has been taking NSAIDs.
- Do Not Miss Diagnoses
- Appendicitis: Although the patient's symptoms do not typically suggest appendicitis, it is a potentially life-threatening condition that requires prompt diagnosis and treatment.
- Intestinal obstruction: A bowel obstruction could be causing the patient's vomiting, and it is essential to rule out this condition to prevent complications.
- Ectopic pregnancy: Although the patient is only 16, it is crucial to consider the possibility of pregnancy, especially if she is sexually active.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis could be causing the patient's symptoms, and it is essential to rule out these conditions to provide appropriate treatment.
- Rare Diagnoses
- Cyclic vomiting syndrome: A rare condition characterized by recurrent episodes of severe vomiting, which could be a possibility if the patient's symptoms are episodic.
- Rumination syndrome: A condition where food is regurgitated and then re-chewed, which could be a possibility if the patient has a history of eating disorders or gastrointestinal issues.
- Gastric volvulus: A rare condition where the stomach twists, which could be causing the patient's vomiting, although it is unlikely.