Differential Diagnosis for High Fever, Anemia, Leukopenia, and Transaminitis
Single Most Likely Diagnosis
- Viral Hepatitis: This condition can cause high fever, anemia due to decreased erythropoiesis, leukopenia from bone marrow suppression, and transaminitis due to liver inflammation. The combination of these symptoms, especially the liver enzyme elevation, points towards a hepatitis infection as a primary cause.
Other Likely Diagnoses
- Sepsis: Can cause high fever, anemia from chronic disease or hemolysis, leukopenia in the early stages due to bone marrow suppression or redistribution of white blood cells, and transaminitis due to liver dysfunction from hypoperfusion or direct infection.
- Malaria: Particularly in endemic areas, malaria can cause high fever, anemia from hemolysis, leukopenia, and transaminitis due to liver involvement.
- Typhoid Fever: Caused by Salmonella Typhi, it can lead to high fever, anemia, leukopenia, and transaminitis due to the systemic infection affecting multiple organs including the liver.
Do Not Miss Diagnoses
- Ebola or Other Viral Hemorrhagic Fevers: Although rare, these conditions can present with high fever, anemia, leukopenia, and transaminitis, and are critical to identify early due to their high mortality rate and public health implications.
- Toxic Shock Syndrome: Can cause high fever, anemia, leukopenia, and transaminitis, along with other systemic symptoms. Early recognition is crucial due to its high mortality rate if not promptly treated.
- Leptospirosis: A zoonotic infection that can cause a wide range of symptoms including high fever, anemia, leukopenia, and transaminitis, particularly in individuals exposed to contaminated water.
Rare Diagnoses
- Hemophagocytic Lymphohistiocytosis (HLH): A rare disorder of the immune system that can cause high fever, anemia, leukopenia, and transaminitis due to the excessive activation and proliferation of lymphocytes and histiocytes.
- Lymphoma: Certain types of lymphoma can cause systemic symptoms including high fever, anemia, leukopenia, and transaminitis, especially if there is liver involvement.
- Ehrlichiosis/Anaplasmosis: Tick-borne illnesses that can cause fever, anemia, leukopenia, and transaminitis, though they are less common and typically associated with specific geographic and exposure histories.