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Differential Diagnosis

  • Single most likely diagnosis
    • Guillain-Barré Syndrome: The patient's history of progressive limb weakness, difficulty turning in bed, and recent fever, along with the presence of sluggish deep tendon reflexes (DTR) in the left lower limb, points towards an acute inflammatory demyelinating polyneuropathy, which is characteristic of Guillain-Barré Syndrome.
  • Other Likely diagnoses
    • Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): Given the patient's history of recurrent radicular pain and now presenting with limb weakness and abdominal discomfort, CIDP could be a consideration, especially if the symptoms have been progressive over time.
    • Spinal Stenosis or Spondylosis: The history of radicular pain in both lower limbs at different times could suggest a spinal cause, such as stenosis or spondylosis, which might be contributing to the current weakness and discomfort.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Spinal Epidural Abscess: Although less likely, the combination of fever, back pain (implied by abdominal discomfort and radicular pain history), and neurological deficits (limb weakness and sluggish DTR) necessitates consideration of a spinal epidural abscess, which is a medical emergency.
    • Cauda Equina Syndrome: This condition, often due to a herniated disk, can cause lower limb weakness, radicular pain, and bowel/bladder dysfunction. The abdominal discomfort could be a non-specific symptom, but the neurological findings warrant its consideration.
  • Rare diagnoses
    • Neurosarcoidosis: This condition can cause a wide range of neurological symptoms, including limb weakness, radicular pain, and systemic symptoms like fever. Although rare, it should be considered in the differential diagnosis, especially if other causes are ruled out.
    • Vasculitis (e.g., Polyarteritis Nodosa): Systemic vasculitis can cause a variety of symptoms, including limb weakness, abdominal pain, and fever. It is a rare but important consideration due to its potential for serious complications if left untreated.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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