Differential Diagnosis for Abdominal Pain, Nausea, Vomiting, Feverishness, and Fatigue
The patient presents with a combination of symptoms that could be indicative of various conditions. The differential diagnosis can be categorized as follows:
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is the most likely diagnosis given the patient's symptoms of abdominal pain, nausea, vomiting, feverishness, and fatigue, which began 1-2 days ago. The recent attendance at a wedding and funeral increases the likelihood of exposure to a viral pathogen. The symptoms of bloating, distention, and constant aching and crampiness in the upper quadrant abdominal pain that extends to bilateral sides are consistent with viral gastroenteritis.
Other Likely Diagnoses
- Food Poisoning: Given the patient's recent attendance at social gatherings where food was likely served, food poisoning is a plausible diagnosis. The symptoms of nausea, vomiting, abdominal pain, and fever are consistent with food poisoning.
- Inflammatory Bowel Disease (IBD) Flare: Although less likely, an IBD flare (e.g., Crohn's disease or ulcerative colitis) could present with similar symptoms, especially if the patient has a pre-existing condition.
- Mesenteric Lymphadenitis: This condition, often caused by a viral infection, can mimic appendicitis or other abdominal conditions, presenting with abdominal pain, nausea, and vomiting.
Do Not Miss Diagnoses
- Appendicitis: Although the pain is not typically localized to the right lower quadrant, appendicitis can present atypically, especially in women. Missing this diagnosis could lead to severe consequences, including perforation and peritonitis.
- Cholecystitis: Inflammation of the gallbladder can cause upper quadrant abdominal pain, nausea, vomiting, and fever. It is crucial not to miss this diagnosis, as it may require urgent surgical intervention.
- Pancreatitis: Acute pancreatitis can present with severe abdominal pain, nausea, vomiting, and fever. It is essential to consider this diagnosis, as it can be life-threatening if not promptly treated.
- Diverticulitis: Infection of a diverticulum in the colon can cause abdominal pain, fever, and changes in bowel habits. Although less common in younger individuals, it should not be missed due to the potential for complications.
Rare Diagnoses
- Intestinal Obstruction: Although less likely, an intestinal obstruction could present with abdominal pain, nausea, vomiting, and bloating. This condition requires prompt diagnosis and treatment to prevent complications.
- Hepatitis: Acute hepatitis can cause abdominal pain, nausea, vomiting, and fever. Although less common, it should be considered, especially if the patient has a history of liver disease or exposure to hepatitis viruses.
- Abdominal Aortic Aneurysm: This condition is rare in younger individuals but can present with abdominal pain and should be considered in the differential diagnosis, especially if the patient has risk factors such as hypertension or a family history of aneurysms.