Differential Diagnosis for Chills, No Fever, and Pain in the Left Lower Quadrant and Left Flank
- Single Most Likely Diagnosis
- Diverticulitis: This condition is characterized by inflammation of the diverticula in the colon, which can cause pain in the left lower quadrant. The absence of fever does not rule out diverticulitis, as some patients may not present with fever. Chills can occur due to the inflammatory response.
- Other Likely Diagnoses
- Kidney Stone (Nephrolithiasis): Pain from a kidney stone can radiate to the flank and lower quadrant, and chills can occur if there is an associated infection or severe pain. The absence of fever does not exclude this diagnosis.
- Constipation: Severe constipation can cause significant abdominal pain and discomfort, potentially radiating to the flank. Chills are less common but can occur due to straining or associated anxiety.
- Irritable Bowel Syndrome (IBS): Although IBS is more chronic, an acute exacerbation could present with severe pain and chills, especially if there is a significant change in bowel habits.
- Do Not Miss Diagnoses
- Appendicitis (even though pain is on the left side, it's rare but possible for the appendix to be located on the left): Appendicitis is a surgical emergency. Although the typical presentation involves pain migrating to the right lower quadrant, variations in appendix location can lead to atypical presentations.
- Ectopic Pregnancy: This is a life-threatening condition that requires immediate attention. Although classically associated with missed periods and vaginal bleeding, some cases may present atypically, especially if the patient is not aware of the pregnancy.
- Ovarian Torsion: Another gynecological emergency that can present with severe, acute pain. It may not always be accompanied by fever, and the pain can radiate to the flank.
- Pyelonephritis: An infection of the kidney that can present with flank pain and systemic symptoms like chills, even in the absence of fever, especially in immunocompromised patients.
- Rare Diagnoses
- Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis): These conditions can cause chronic inflammation and acute exacerbations leading to severe pain and systemic symptoms.
- Intussusception: A condition where a part of the intestine telescopes into another, which can cause severe abdominal pain and is more common in children but can occur in adults.
- Retroperitoneal Fibrosis: A rare condition characterized by the proliferation of fibrous tissue in the retroperitoneum, which can cause abdominal and flank pain due to the encasement of structures like the ureters.