Differential Diagnosis for Tristan's Sore Tummy
Given Tristan's symptoms and medical history, the following differential diagnoses can be considered:
- Single most likely diagnosis
- Gastroenteritis: This is a common condition that can cause a sore tummy and is often self-limiting. The fact that Tristan has no other specific concerns or symptoms and is experiencing this for the first time makes a viral or bacterial gastrointestinal infection a plausible explanation.
- Other Likely diagnoses
- Side effects of Cabenuva injections: Although Tristan is undergoing HIV treatment with Cabenuva, gastrointestinal side effects can occur with any medication, including antiretroviral therapy. It's possible that the sore tummy is related to the treatment.
- Irritable Bowel Syndrome (IBS): Given the lack of other symptoms, IBS could be considered, especially if Tristan experiences recurring abdominal pain or changes in bowel habits.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- HIV-related opportunistic infections (e.g., CMV colitis, MAC infection): Although Tristan is on treatment, the possibility of an opportunistic infection, especially if his viral load is not well controlled, cannot be overlooked.
- Gastrointestinal malignancy: Although rare, especially in someone with a relatively recent HIV diagnosis, the possibility of a gastrointestinal cancer (e.g., lymphoma) should be considered, particularly if other risk factors are present.
- Acute abdomen (e.g., appendicitis, perforated viscus): These conditions require immediate medical attention and can present with nonspecific abdominal pain.
- Rare diagnoses
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions are less common but can cause chronic abdominal symptoms.
- Pancreatitis: Although less likely without other symptoms like severe pain or vomiting, pancreatitis can occur and needs to be considered, especially if Tristan has risk factors such as hypertriglyceridemia or gallstones.
- Medication-induced pancreatitis or hepatitis: Some antiretroviral medications can cause pancreatitis or hepatitis, although this is rare with Cabenuva.