Differential Diagnosis for Fever and Vomiting for 2 Months
Single Most Likely Diagnosis
- Inflammatory bowel disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis, which can cause chronic inflammation of the gastrointestinal tract, leading to symptoms such as fever, vomiting, diarrhea, and abdominal pain. The chronic nature of the symptoms fits with the prolonged duration of IBD.
Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): Although more commonly associated with heartburn, severe GERD can lead to vomiting and, in some cases, fever if there's an associated infection or esophagitis.
- Peptic ulcer disease: Gastric or duodenal ulcers can cause vomiting and may be associated with fever, especially if there's a complication like perforation or bleeding.
- Chronic infections (e.g., tuberculosis, brucellosis): Certain chronic infections can present with prolonged fever and gastrointestinal symptoms, including vomiting.
- Malignancy (e.g., gastric cancer): Though less common, cancers of the stomach or other parts of the gastrointestinal tract can cause chronic symptoms like vomiting and fever.
Do Not Miss Diagnoses
- Appendicitis with rupture or abscess formation: Although appendicitis typically presents acutely, a ruptured appendix can lead to a chronic, smoldering infection with prolonged fever and vomiting.
- Intestinal obstruction: This can cause severe vomiting and, if not promptly treated, can lead to fever due to bowel ischemia or perforation.
- Pancreatitis: Chronic pancreatitis can cause recurrent episodes of vomiting and may be associated with fever, especially if there's an infectious component.
Rare Diagnoses
- Whipple's disease: A rare, systemic bacterial infection that can cause chronic diarrhea, weight loss, and fever, among other symptoms.
- Eosinophilic gastroenteritis: A condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to symptoms like vomiting, diarrhea, and abdominal pain.
- Cyclic vomiting syndrome: A disorder characterized by recurrent, severe episodes of vomiting, which can be associated with fever in some cases.
- Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE): A rare genetic disorder affecting the gastrointestinal system and nervous system, leading to symptoms like vomiting, diarrhea, and abdominal pain, along with neurologic manifestations.