Differential Diagnosis for Sudden Spike of Fever with High Inflammatory Markers
Single Most Likely Diagnosis
- Sepsis: A sudden spike in fever accompanied by high inflammatory markers (such as CRP and ESR) that does not subside with paracetamol suggests a severe infection. Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. The high inflammatory markers and the severity of the fever are consistent with a systemic infection, making sepsis a highly plausible diagnosis.
Other Likely Diagnoses
- Pneumonia: This is an infection in one or both lungs. Bacteria, viruses, and fungi can cause it. Symptoms include cough, fever, and difficulty breathing. High inflammatory markers can be present, and the condition can be severe enough that paracetamol may not sufficiently reduce the fever.
- Pyelonephritis: An infection of the kidney, typically caused by bacteria. It can cause severe fever, flank pain, and high inflammatory markers. The infection can be severe enough that the fever does not respond to paracetamol.
- Meningitis: An infection of the protective membranes covering the brain and spinal cord, known as the meninges. This infection can be life-threatening and is characterized by fever, headache, and stiff neck. High inflammatory markers are common, and the fever may not subside with paracetamol.
Do Not Miss Diagnoses
- Endocarditis: An infection of the inner lining of the heart chambers and valves. It's a serious condition that can be life-threatening if not treated promptly. Symptoms can include fever, which may not respond to paracetamol, and high inflammatory markers.
- Appendicitis: Inflammation of the appendix, which can cause severe abdominal pain, fever, and high inflammatory markers. While the primary symptom is pain, the fever and elevated inflammatory markers are critical for diagnosis.
- Diverticulitis: Inflammation or infection of small pouches called diverticula that can form in the walls of the intestines. Symptoms include severe abdominal pain, fever, and high inflammatory markers. The condition requires prompt medical attention.
Rare Diagnoses
- Familial Mediterranean Fever: A rare genetic disorder characterized by recurrent episodes of painful inflammation in the abdomen, chest, or joints. It can cause high fever and elevated inflammatory markers, but it is much less common than the other conditions listed.
- Adult-Onset Still's Disease: A rare disorder that causes high fevers, salmon-colored rash, and joint pain, among other symptoms. It can also lead to high inflammatory markers and may not respond to paracetamol.
- Lymphoma: A group of blood cell tumors that can cause fever, night sweats, and weight loss, among other symptoms. While less likely, lymphoma can present with high inflammatory markers and should be considered in the differential diagnosis, especially if other symptoms or findings suggest it.