Differential Diagnosis
- Single most likely diagnosis
- Exertional heat stroke: This is the most likely diagnosis given the patient's symptoms of profound generalized weakness, lightheadedness, nausea, vomiting, and sweating profusely after intense physical activity in a warm environment. The patient's elevated temperature (39 C) and rapid pulse (136/min) also support this diagnosis.
- Other Likely diagnoses
- Heat exhaustion: This is a possible diagnosis, as the patient exhibits symptoms such as sweating, nausea, vomiting, and abdominal cramps. However, the presence of a high fever and severe weakness makes exertional heat stroke more likely.
- Cystic fibrosis exacerbation: Although the patient has cystic fibrosis, the acute presentation of symptoms such as profound weakness, lightheadedness, and vomiting is more suggestive of a heat-related illness than a cystic fibrosis exacerbation.
- Do Not Miss
- Traumatic brain injury: The patient bumped heads with another player, and although she did not lose consciousness, it is essential to consider the possibility of a traumatic brain injury, which could be life-threatening if missed.
- Dehydration with electrolyte imbalance: The patient's symptoms of vomiting, abdominal cramps, and sweating could lead to dehydration and electrolyte imbalances, which need to be addressed promptly to prevent further complications.
- Rare diagnoses
- Exertional hypernatremia: This is a rare condition that occurs when there is an imbalance of sodium and water in the body during intense physical activity. Although it is possible, the patient's symptoms are more consistent with exertional heat stroke.
- Hyperchloremic dehydration: This is a rare condition that can occur in patients with cystic fibrosis, but it is not as likely given the patient's acute presentation of symptoms consistent with a heat-related illness.