Differential Diagnosis
The patient's condition with two or more SIRS (Systemic Inflammatory Response Syndrome) criteria, an infection, and end-organ dysfunction is concerning for several diagnoses. Here is a categorized differential diagnosis:
- Single most likely diagnosis
- Sepsis: This is the most likely diagnosis, as it is defined by the presence of an infection, two or more SIRS criteria, and end-organ dysfunction. The patient's symptoms align with the diagnostic criteria for sepsis.
- Other Likely diagnoses
- Severe sepsis: This diagnosis is likely if the patient has sepsis with associated organ dysfunction, but not necessarily septic shock.
- Septic shock: This diagnosis is possible if the patient has sepsis with associated hypotension and end-organ dysfunction, despite adequate fluid resuscitation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Toxic shock syndrome: Although less common, toxic shock syndrome can present with similar symptoms to sepsis and has a high mortality rate if not promptly recognized and treated.
- Necrotizing fasciitis: This is a rare but life-threatening condition that requires prompt surgical intervention and may present with signs of sepsis and end-organ dysfunction.
- Rare diagnoses
- Meningococcemia: This is a rare but severe infection caused by Neisseria meningitidis, which can present with signs of sepsis and end-organ dysfunction.
- Rocky Mountain spotted fever: This is a rare tick-borne illness that can cause severe sepsis and end-organ dysfunction if not promptly recognized and treated.