Differential Diagnosis
The patient's presentation with fever, body aches, leukopenia, thrombocytopenia, elevated liver enzymes, and bilirubin levels suggests a systemic illness. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Viral hepatitis: The elevated AST, ALT, and bilirubin levels, along with the patient's symptoms, are consistent with viral hepatitis. The leukopenia and thrombocytopenia can also be seen in viral hepatitis due to bone marrow suppression or splenic sequestration.
- Other Likely diagnoses
- Severe viral infection (e.g., influenza, COVID-19): These infections can cause systemic symptoms, leukopenia, and elevated liver enzymes.
- Mononucleosis: Caused by Epstein-Barr virus (EBV), it can present with fever, body aches, leukopenia, and elevated liver enzymes.
- Tick-borne illnesses (e.g., anaplasmosis, ehrlichiosis): Given the patient's location in upstate NY, tick-borne illnesses are a possibility, and can cause fever, body aches, leukopenia, and elevated liver enzymes.
- Do Not Miss
- Sepsis: Although the patient's symptoms are non-specific, sepsis can present with fever, body aches, and elevated liver enzymes. It's essential to consider sepsis due to its high mortality rate if left untreated.
- Hemophagocytic lymphohistiocytosis (HLH): A rare but life-threatening condition that can cause fever, body aches, leukopenia, and elevated liver enzymes.
- Acute liver failure: The patient's elevated liver enzymes and bilirubin levels could indicate acute liver failure, which requires prompt recognition and treatment.
- Rare diagnoses
- Autoimmune hepatitis: Although less likely, autoimmune hepatitis can cause elevated liver enzymes and bilirubin levels, along with systemic symptoms.
- Wilson's disease: A rare genetic disorder that can cause liver dysfunction, leukopenia, and thrombocytopenia.
- Lymphoma: Some types of lymphoma can cause systemic symptoms, leukopenia, and elevated liver enzymes, although this is a less likely diagnosis given the patient's presentation.