Differential Diagnosis for 76-year-old Male with Parkinson's, Diarrhea, and Vomiting
- Single most likely diagnosis
- Gastroenteritis: This is a common cause of diarrhea and vomiting in the elderly, and the absence of fever does not rule out this diagnosis. The patient's age and Parkinson's disease may increase his susceptibility to dehydration and electrolyte imbalances.
- Other Likely diagnoses
- Medication-induced gastrointestinal side effects: The patient's Parkinson's disease medications, such as dopamine agonists or levodopa, can cause gastrointestinal side effects like nausea, vomiting, and diarrhea.
- Viral gastroenteritis: Although the patient does not have a fever, viral gastroenteritis can still occur without fever, especially in the elderly.
- Food poisoning: This is another possible cause of acute diarrhea and vomiting, especially if the patient has recently consumed contaminated or spoiled food.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Bowel obstruction: Although less likely, a bowel obstruction can cause severe vomiting and diarrhea, and if missed, can lead to severe complications, including bowel ischemia and perforation.
- Mesenteric ischemia: This is a life-threatening condition that can cause abdominal pain, vomiting, and diarrhea, and requires prompt diagnosis and treatment.
- Neuroleptic malignant syndrome (NMS): Although rare, NMS is a life-threatening condition that can occur in patients with Parkinson's disease, especially those taking dopamine antagonists or withdrawing from dopamine agonists.
- Rare diagnoses
- Parkinson's disease-related autonomic dysfunction: Some patients with Parkinson's disease can experience autonomic dysfunction, which can cause gastrointestinal symptoms like diarrhea and vomiting.
- Lewy body dementia: This is a rare condition that can cause fluctuations in cognitive function, hallucinations, and autonomic dysfunction, including gastrointestinal symptoms.