What is the diagnosis for a 31-year-old healthy female who recently returned from a 1-week trip to northern Vietnam, presenting with a 4-day history of non-productive dry cough, pharyngitis, and laryngitis, followed by a productive cough, severe nasal congestion, conjunctivitis, high fever responsive to Tylenol (acetaminophen), and new-onset diarrhea?

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Differential Diagnosis

  • Single most likely diagnosis
    • Influenza: The patient's symptoms, including a non-productive cough, sore throat, laryngitis, severe nasal congestion, conjunctivitis, high fever, and diarrhea, are consistent with a viral respiratory infection. The recent travel to northern Vietnam and the sudden onset of symptoms also support this diagnosis.
  • Other Likely diagnoses
    • Common cold: Although the symptoms are more severe, the common cold is a possibility, especially given the productive cough and nasal congestion.
    • Respiratory syncytial virus (RSV) infection: RSV can cause severe respiratory symptoms, including cough, sore throat, and conjunctivitis, especially in adults who have been exposed to the virus while traveling.
    • Adenovirus infection: Adenovirus can cause a range of symptoms, including respiratory symptoms, conjunctivitis, and fever, which are consistent with the patient's presentation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • SARS-CoV-2 (COVID-19): Although the patient has recently traveled to northern Vietnam, COVID-19 is still a possibility, especially given the respiratory symptoms and fever.
    • Avian influenza (H5N1 or H7N9): The patient's recent travel to northern Vietnam, a region with reported cases of avian influenza, and the severity of symptoms, including high fever and respiratory symptoms, make this a "do not miss" diagnosis.
    • Meningococcal infection: Although less likely, meningococcal infection can present with fever, sore throat, and conjunctivitis, and can be deadly if not promptly treated.
  • Rare diagnoses
    • Hantavirus infection: The patient's recent travel to northern Vietnam and the symptoms of fever, cough, and diarrhea could be consistent with hantavirus infection, although this is a rare diagnosis.
    • Leptospirosis: The patient's symptoms, including fever, cough, and diarrhea, could be consistent with leptospirosis, although this is a rare diagnosis and would require exposure to contaminated water or soil.

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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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