Differential Diagnosis
- Single most likely diagnosis
- Vaping-Related Illness (EVALI): Given the patient's vaping habit and symptoms such as cough, fever, and nausea, EVALI is a strong consideration. The recent flu-like illness could also be a contributing factor, as some cases of EVALI have been linked to respiratory infections.
- Other Likely diagnoses
- Pneumonia: The patient's symptoms of cough, fever, and nausea could be indicative of pneumonia, especially in the context of a recent flu-like illness.
- Gastroenteritis: The symptoms of nausea, vomiting, and loss of appetite could suggest a gastrointestinal infection.
- Influenza: Although the patient has already had the flu, it's possible that she has developed a secondary infection or is experiencing a prolonged recovery.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary Embolism: Although less likely, a pulmonary embolism could present with cough, fever, and nausea, and would be a life-threatening condition if missed.
- Sepsis: If the patient's symptoms are due to a bacterial infection, sepsis is a possibility that should not be missed, as it can be fatal if not promptly treated.
- Tuberculosis: Given the patient's Pakistani background, tuberculosis is a possibility that should be considered, especially if the patient has been exposed to someone with TB or has a weakened immune system.
- Rare diagnoses
- Cystic Fibrosis Exacerbation: Although rare, cystic fibrosis could be a consideration if the patient has a history of the disease, and the symptoms are consistent with an exacerbation.
- Lung Cancer: Although unlikely in a 32-year-old, lung cancer could be a rare consideration, especially if the patient has a significant smoking or vaping history.
- Histoplasmosis: If the patient has been exposed to bird or bat droppings, histoplasmosis is a rare fungal infection that could present with similar symptoms.