Differential Diagnosis

The patient presents with a combination of symptoms including sore throat, dry cough, weakness, fever, and a rash in the trunk area, along with epidemiological history of exposure to mice. Based on these findings, the differential diagnoses can be categorized as follows:

• Single Most Likely Diagnosis

  • Yersiniosis, acute respiratory form, moderate severity: This diagnosis is considered most likely due to the patient's exposure to mice, which can carry Yersinia pestis, the bacterium responsible for plague. The symptoms of sore throat, dry cough, fever, and rash are consistent with the acute respiratory form of the disease. The presence of mice in the basement of the patient's home provides a strong epidemiological link.

• Other Likely Diagnoses

  • Influenza, severe form: Although influenza could explain the respiratory symptoms and fever, the presence of a rash and the specific epidemiological history of exposure to mice make it less likely than Yersiniosis.
  • Paratyphoid B, moderate form: This diagnosis could be considered due to the fever and gastrointestinal symptoms (enlarged liver, semi-formed stool), but the respiratory symptoms and rash are not typical for paratyphoid fever.
  • Acute viral hepatitis B, jaundice form, moderate severity: The patient does not exhibit jaundice, which is a hallmark of hepatitis B, making this diagnosis less likely. The liver enlargement could be seen in various conditions, including infections.

• Do Not Miss Diagnoses

  • Listeriosis, primary focal form (anginous) form, moderate severity: Although less common, listeriosis can present with a wide range of symptoms including fever, respiratory symptoms, and can be severe. It's particularly important to consider in immunocompromised individuals or those with specific risk factors, though the patient's profile does not specifically suggest these.
  • Influenza, severe form: Given the potential for severe outcomes, especially in certain populations, it's crucial not to miss influenza, despite it being less likely based on the rash and epidemiological history.

• Rare Diagnoses

  • Other zoonotic diseases (diseases transmitted from animals to humans) could be considered rare diagnoses, given the patient's exposure to mice. However, Yersiniosis is the most directly linked to the patient's symptoms and history.
  • Certain viral exanthems (rash-causing viruses) could also present with similar symptoms but are less likely given the specific combination of symptoms and the epidemiological context.