Differential Diagnosis for Homeless Patient with Angioedema and Petechiae
- Single most likely diagnosis:
- Scurvy: This condition, caused by vitamin C deficiency, can lead to poor collagen synthesis, resulting in fragile blood vessels that can cause petechiae and potentially angioedema. The spider-web pattern petechiae, also known as perifollicular petechiae, are characteristic of scurvy. The patient's homeless status increases the likelihood of malnutrition and vitamin deficiency.
- Other Likely diagnoses:
- Henoch-Schönlein Purpura (HSP): Although HSP typically presents with palpable purpura, abdominal pain, and arthritis, it can sometimes cause angioedema. The petechiae could be an atypical presentation of HSP.
- Infectious Endocarditis: This condition can cause petechiae due to septic emboli or immune complex deposition. Angioedema could be a rare manifestation of an allergic reaction to the infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningococcemia: This severe infection can cause petechiae or purpura, and angioedema could be a rare presentation. It is essential to consider this diagnosis due to its high mortality rate if left untreated.
- Thrombotic Thrombocytopenic Purpura (TTP): Although TTP typically presents with thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and neurological symptoms, it can sometimes cause petechiae and angioedema.
- Rare diagnoses:
- Ehlers-Danlos Syndrome: This genetic disorder can cause fragile blood vessels, leading to petechiae and potentially angioedema. However, it is a rare condition and would be less likely in this scenario.
- Amyloidosis: This condition can cause angioedema and petechiae due to the deposition of amyloid proteins in blood vessels. However, it is a rare diagnosis and would require further evaluation to confirm.