Differential Diagnosis for 64-year-old Female with Recent Hernia Repair
Single most likely diagnosis
- Surgical site infection: Given the recent hernia repair 16 days ago, a surgical site infection is a common complication that can occur, especially if the patient has been experiencing fever. The proximity of the symptoms to the surgical procedure makes this a highly plausible diagnosis.
Other Likely diagnoses
- Urinary Tract Infection (UTI): Fever and dizziness can be symptoms of a UTI, especially in older adults. The recent surgery may have increased the risk of UTI due to catheterization or immobility.
- Pneumonia: Postoperative pneumonia is a risk, particularly if the patient had general anesthesia or has underlying respiratory conditions. Fever and dizziness could be indicative of pneumonia.
- Deep Vein Thrombosis (DVT): Immobility after surgery increases the risk of DVT, which can cause dizziness due to pulmonary embolism if the clot dislodges.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although less likely, sepsis is a life-threatening condition that can arise from any infection, including surgical site infections or UTIs. Early recognition is crucial.
- Pulmonary Embolism: A possible complication of DVT, pulmonary embolism can present with dizziness among other symptoms and is immediately life-threatening.
- Adrenal insufficiency: If the patient has been on long-term steroids, adrenal insufficiency could be a consideration, especially with symptoms like dizziness and fever.
Rare diagnoses
- Intra-abdominal abscess: A possible complication of hernia repair, an intra-abdominal abscess could cause fever but might be less likely without significant abdominal pain or tenderness.
- Endocarditis: Although rare, endocarditis could be considered if the patient has a history of heart disease or valve problems, presenting with fever and possibly dizziness due to embolic events.