Differential Diagnosis for 29-year-old Female with Diarrhea and Nausea
- Single most likely diagnosis:
- Viral Gastroenteritis: This is the most likely diagnosis given the patient's symptoms of diarrhea and nausea, which are common presentations of viral gastroenteritis. The fact that she was able to recover briefly before symptoms recurred also fits with the typical course of this illness.
- Other Likely diagnoses:
- Food Poisoning: Although the patient's symptoms have lasted longer than typical food poisoning, it is still a possible diagnosis, especially if she consumed contaminated food on Thursday.
- Irritable Bowel Syndrome (IBS): Given the patient's history of diarrhea and nausea, IBS could be considered, especially if she has a history of similar episodes.
- Inflammatory Bowel Disease (IBD): Although less likely, IBD (e.g., Crohn's disease or ulcerative colitis) could present with similar symptoms, especially if this is the patient's first episode.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although the patient denies vomiting and has been afebrile, appendicitis can present atypically, especially in young women. It is crucial to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Intestinal Obstruction: This is another critical diagnosis to consider, as it can present with nausea, vomiting, and abdominal pain, although the patient's symptoms have been relatively mild.
- Inflammatory or Infectious Colitis (e.g., Clostridioides difficile): These conditions can cause severe diarrhea and nausea, and it is essential to consider them, especially if the patient has recently taken antibiotics or has a compromised immune system.
- Rare diagnoses:
- Giardiasis: This parasitic infection can cause chronic diarrhea and nausea, although it is less common in immunocompetent individuals.
- Lactose Intolerance or other Malabsorptive Disorders: These conditions can cause similar symptoms, especially if the patient has recently changed her diet or has a family history of these disorders.
- Neurological or Psychiatric Disorders (e.g., cyclic vomiting syndrome): Although rare, these conditions can present with nausea and vomiting, and it is essential to consider them if other diagnoses are ruled out.