Differential Diagnosis for 45 YOF with UTI Symptoms on Chemo for Metastatic Breast Cancer
- Single Most Likely Diagnosis
- Febrile Neutropenia: Given the patient's low WBC count (1.3) while on chemotherapy, febrile neutropenia is a highly likely diagnosis. The presence of UTI symptoms and elevated CRP (26.3) further supports this, as febrile neutropenia can predispose patients to infections.
- Other Likely Diagnoses
- Sepsis: With UTI symptoms, elevated CRP, and a low WBC count, sepsis is a possible diagnosis. The patient's compromised immune system due to chemotherapy increases the risk of sepsis.
- Chemotherapy-induced Myelosuppression: The patient's low blood cell counts (WBC 1.3, Hb 83, platelets 110) are consistent with myelosuppression, a common side effect of chemotherapy.
- Do Not Miss Diagnoses
- Septic Shock: Although the patient's blood pressure is not provided, septic shock is a potentially deadly condition that must be considered, especially given the signs of possible sepsis and the patient's immunocompromised state.
- Hemorrhagic Cystitis: This is a condition associated with certain chemotherapeutic agents and can present with UTI-like symptoms. It's crucial to consider due to the patient's chemotherapy treatment.
- Rare Diagnoses
- Neutropenic Colitis (Typhlitis): This is a rare but serious condition that can occur in neutropenic patients, characterized by inflammation of the colon. While less likely, it should be considered in the differential due to the patient's neutropenia and UTI symptoms.
- Disseminated Intravascular Coagulation (DIC): Given the patient's thrombocytopenia (platelets 110) and potential for sepsis, DIC is a rare but potentially deadly condition that should not be overlooked.