What is the diagnosis for a patient presenting with cough, diarrhea, vomiting, and shortness of breath (SOB) for 1.5 weeks, accompanied by fever, left anterior rib pain, and mild hypoxemia with an oxygen saturation level of 93% on room air?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 26, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Cough, Diarrhea, Vomiting, and SOB

Single Most Likely Diagnosis

  • Viral Gastroenteritis with Respiratory Involvement: This diagnosis is likely due to the combination of gastrointestinal symptoms (diarrhea, vomiting) and respiratory symptoms (cough, SOB) along with fever, which are common in viral infections. The presence of left anterior rib pain could be related to coughing or viral myositis.

Other Likely Diagnoses

  • Influenza: Given the symptoms of cough, fever, and shortness of breath, influenza is a plausible diagnosis, especially during flu season. The gastrointestinal symptoms could be part of the influenza syndrome.
  • Pneumonia: The symptoms of cough, fever, shortness of breath, and rib pain (possibly due to pleurisy) could indicate pneumonia, which can be caused by viral or bacterial pathogens.
  • Gastroesophageal Reflux Disease (GERD) with Respiratory Symptoms: GERD can cause cough and vomiting, and if severe, could lead to respiratory symptoms due to aspiration or reflex mechanisms.

Do Not Miss Diagnoses

  • Pulmonary Embolism: Although less likely, pulmonary embolism is a critical diagnosis not to miss due to its high mortality rate. The shortness of breath and chest pain (referred to as rib pain) could be indicative of a pulmonary embolism.
  • Pneumothorax: The combination of shortness of breath and chest pain could also suggest a pneumothorax, especially if the patient has underlying lung disease.
  • Sepsis: If the patient's condition is severe, with significant fever, vomiting, and shortness of breath, sepsis from a bacterial infection (either gastrointestinal or respiratory) must be considered due to its high mortality rate.

Rare Diagnoses

  • Tuberculosis: Although rare in many areas, tuberculosis can present with chronic cough, fever, and weight loss, and less commonly with gastrointestinal symptoms.
  • Cystic Fibrosis Exacerbation: In patients with known cystic fibrosis, an exacerbation could present with increased respiratory and gastrointestinal symptoms.
  • Eosinophilic Pneumonia: A rare condition that can cause respiratory symptoms, eosinophilic pneumonia might also present with gastrointestinal symptoms in some cases.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.