Differential Diagnosis

The patient's symptoms of diarrhea, abdominal discomfort, nausea, and bad taste in her mouth, which worsened with food intake, suggest several possible diagnoses. Here's a categorized differential diagnosis:

• Single most likely diagnosis
  • Gastroenteritis: This is the most likely diagnosis given the acute onset of symptoms after consuming a hot dog at a soccer game, suggesting a possible infectious cause. The symptoms of diarrhea, abdominal discomfort, and nausea are consistent with gastroenteritis. The fact that her symptoms worsen with food intake also supports this diagnosis.
• Other Likely diagnoses
  • Irritable Bowel Syndrome (IBS): Although less likely given the acute onset, IBS could be considered if the symptoms persist and no infectious cause is found. The abdominal discomfort and alteration in bowel habits are consistent with IBS.
  • Food intolerance: The patient's symptoms worsening with food intake could suggest a food intolerance, such as lactose intolerance or gluten intolerance, although the acute onset after a specific event makes this less likely.
  • Medication-induced diarrhea: The use of an unknown antibiotic (Flogly) from Turkey could potentially cause diarrhea, although the timing and the fact that she only took it a few times make this less likely.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic diarrhea, abdominal pain, and weight loss. Although less likely given the acute onset, missing IBD could lead to significant morbidity.
  • Giardiasis: An infectious cause that can lead to chronic diarrhea if not treated. It's essential to consider this, especially if the patient's symptoms persist.
  • Clostridioides difficile (C. diff) infection: Given the patient's use of antibiotics, even if it was only a few doses, C. diff infection is a critical diagnosis not to miss, as it can lead to severe complications.
• Rare diagnoses
  • Whipple's disease: A rare, systemic bacterial infection that can cause chronic diarrhea, weight loss, and abdominal pain. It's essential to consider this in the differential diagnosis, although it's much less likely.
  • Short bowel syndrome: Although unlikely given the acute onset, if the patient has a history of intestinal surgery or injury, short bowel syndrome could be a consideration.
  • Malabsorption syndromes: Conditions like celiac disease or pancreatic insufficiency can cause chronic diarrhea and malabsorption. These are less likely given the acute onset but should be considered if symptoms persist.