What is the diagnosis for a 35-year-old female presenting with a 20-day history of pharyngitis and laryngitis, accompanied by fatigue, and recently developed gastrointestinal symptoms, including nausea, vomiting, and diarrhea, with a negative rapid strep (streptococcal) test and pending stool cultures?

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Differential Diagnosis

  • Single most likely diagnosis
    • Viral gastroenteritis: The patient's symptoms of nausea, vomiting, and diarrhea, especially after a social gathering with various foods, suggest a viral cause. The absence of fever, abdominal pain, and hematochezia also points towards a viral etiology.
  • Other Likely diagnoses
    • Food poisoning: The recent consumption of different foods at a gathering increases the risk of foodborne illness. The symptoms of nausea, vomiting, and diarrhea are consistent with food poisoning.
    • Viral pharyngitis: The patient's initial symptoms of sore throat and laryngitis, which persisted for 20 days, could be due to a viral cause. The negative rapid strep test supports this diagnosis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Botulism: Although rare, botulism can cause symptoms like nausea, vomiting, and diarrhea, especially after consuming contaminated food. It is essential to consider this diagnosis due to its potential severity and the need for prompt treatment.
    • Norovirus infection: Norovirus can cause severe gastroenteritis, and its diagnosis is crucial due to its high contagiousness and potential for outbreaks.
  • Rare diagnoses
    • Giardiasis: This parasitic infection can cause gastrointestinal symptoms like diarrhea, but it is less likely given the patient's recent food exposure and lack of other symptoms like weight loss or abdominal cramps.
    • Inflammatory bowel disease (IBD): Although IBD can cause chronic gastrointestinal symptoms, it is less likely in this case due to the acute onset of symptoms and the patient's recent food exposure.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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