Differential Diagnosis for Fever, Elevated WBC, Nausea, Vomiting, and Diarrhea
Single Most Likely Diagnosis
- Gastroenteritis: This is the most likely diagnosis due to the combination of symptoms such as fever, nausea, vomiting, and diarrhea, which are commonly seen in viral or bacterial gastroenteritis. The elevated WBC count also supports an infectious cause.
Other Likely Diagnoses
- Food Poisoning: Similar to gastroenteritis, food poisoning can cause fever, nausea, vomiting, and diarrhea, often with an elevated WBC count. The onset of symptoms is usually rapid after consuming contaminated food.
- Inflammatory Bowel Disease (IBD) Flare: Patients with IBD (Crohn's disease or ulcerative colitis) can experience exacerbations characterized by fever, elevated WBC, nausea, vomiting, and diarrhea.
- Appendicitis: Although appendicitis typically presents with abdominal pain, fever, and elevated WBC, some patients may also experience nausea, vomiting, and diarrhea, especially if the appendix is near the intestines.
Do Not Miss Diagnoses
- Septicemia: It's crucial not to miss septicemia, as it can be life-threatening. Symptoms can include fever, elevated WBC, nausea, vomiting, and diarrhea, especially if the infection is originating from the gastrointestinal tract.
- Perforated Viscus: A perforation in the gastrointestinal tract can lead to peritonitis, presenting with fever, elevated WBC, nausea, vomiting, and possibly diarrhea. This condition requires immediate surgical intervention.
- Mesenteric Ischemia: This condition involves insufficient blood flow to the intestines and can cause fever, abdominal pain, nausea, vomiting, and diarrhea. It's a medical emergency that requires prompt diagnosis and treatment.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause fever, weight loss, diarrhea, and abdominal pain. It's essential to consider in patients with persistent symptoms and no clear diagnosis.
- Tropical Infections (e.g., Typhoid Fever): In patients who have traveled to or are from endemic areas, tropical infections like typhoid fever can present with fever, elevated WBC, nausea, vomiting, and diarrhea.
- Neutropenic Colitis: This condition occurs in patients with neutropenia (low neutrophil count) and can cause fever, abdominal pain, and diarrhea. It's a rare but serious condition that requires prompt treatment.