Differential Diagnosis for Low Back Pain, Fever, and Worsening Nausea at 12 Weeks Gestation
- Single Most Likely Diagnosis
- Pyelonephritis: This condition is a common cause of low back pain and fever, especially in pregnant women due to urinary tract changes. The worsening nausea could be attributed to the systemic effects of the infection or the pregnancy itself.
- Other Likely Diagnoses
- Urinary Tract Infection (UTI): Similar to pyelonephritis, a UTI could cause low back pain and fever. Nausea might be less commonly associated but could occur due to the infection's systemic effects.
- Kidney Stones: Although less common in pregnancy, kidney stones can cause severe back pain and nausea. Fever might not be a primary symptom but could occur if there's an associated infection.
- Preterm Labor: At 12 weeks, the risk of preterm labor is a concern. Back pain, fever (if there's an infection), and nausea could be symptoms, though typically, more prominent symptoms like regular uterine contractions would be present.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: Although the patient is at 12 weeks gestation, an ectopic pregnancy can still present with back pain and systemic symptoms like nausea and fever, especially if there's rupture or significant bleeding.
- Appendicitis: Appendicitis can present with back pain, nausea, and fever. In pregnancy, the appendix's position can shift, potentially altering the typical presentation of pain.
- Placenta Previa or Abruption: These placental issues can cause back pain and systemic symptoms. Fever might be less common but could occur, especially with abruption if there's an associated infection.
- Rare Diagnoses
- Osteomyelitis or Discitis: Infection of the bone or disc could cause back pain and fever. These conditions are less common and might not typically present with nausea unless the infection is severe.
- Spinal Epidural Abscess: A rare but serious condition that could cause back pain, fever, and systemic symptoms like nausea due to the compression of the spinal cord.