Differential Diagnosis for Pounding Pressure Headache, Eye Pressure, Body Ache, and Low-Grade Fever in a 37-Year-Old Female

• Single Most Likely Diagnosis
  • Tension headache or migraine: These are common conditions that can cause pounding pressure headaches, eye pressure, and body aches. The low-grade fever could be coincidental or related to a viral infection that triggers or exacerbates the headache.
• Other Likely Diagnoses
  • Sinusitis: Inflammation of the sinuses can cause pressure headaches, eye pressure, and body aches, especially if there's an accompanying low-grade fever indicating an infectious component.
  • Viral infection (e.g., flu, common cold): Many viral infections can cause these symptoms, including headaches, body aches, and low-grade fevers.
  • Menstrual or hormonal headache: For a female patient, hormonal changes could contribute to headaches, body aches, and possibly low-grade fever, especially if related to the menstrual cycle.
• Do Not Miss Diagnoses
  • Subarachnoid hemorrhage: Although less likely, this is a critical diagnosis to consider due to its high morbidity and mortality. The sudden onset of a severe headache (often described as "the worst headache of my life") could be accompanied by other symptoms like body aches and fever, especially if there's an associated infection or reaction to the bleed.
  • Meningitis: Infection of the meninges can cause severe headache, fever, and body aches. The presence of eye pressure could be related to increased intracranial pressure.
  • Temporal arteritis: This condition, more common in older adults but possible in younger individuals, can cause headaches, eye pain, and systemic symptoms like fever and body aches.
• Rare Diagnoses
  • Idiopathic intracranial hypertension (IIH): Characterized by increased intracranial pressure without a detectable cause, leading to symptoms like headache, eye pressure, and sometimes fever if there's an associated condition.
  • Brain tumor: Although rare, a brain tumor could cause increased intracranial pressure, leading to headaches, eye pressure, and possibly body aches and fever, especially if the tumor obstructs the normal flow of cerebrospinal fluid.
  • Lyme disease: In endemic areas, Lyme disease can cause a variety of symptoms, including headaches, fever, and body aches, especially in its early stages.