Differential Diagnosis for 22 yo with Cold-like Symptoms

The patient presents with cold-like symptoms accompanied by nausea, headache, heartburn, and constipation. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Viral upper respiratory tract infection (URTI): This is the most common cause of cold-like symptoms. The additional symptoms of nausea, headache, and constipation can sometimes accompany a viral URTI, possibly due to the body's inflammatory response or dehydration.

• Other Likely Diagnoses

  • Gastroesophageal reflux disease (GERD): The symptoms of heartburn and nausea could suggest GERD, especially if the patient has a history of GERD or if these symptoms persist or worsen over time.
  • Viral gastroenteritis: Although the primary symptoms are cold-like, the presence of nausea and constipation might also suggest a viral gastroenteritis, especially if there's been exposure to someone with similar symptoms or if the patient has recently traveled.
  • Sinusitis: If the cold-like symptoms are severe or persistent, and especially if there's facial pain or purulent nasal discharge, sinusitis could be a consideration.

• Do Not Miss Diagnoses

  • Appendicitis: Although less likely given the cold-like symptoms, appendicitis can sometimes present atypically, especially in young women, with nausea, vomiting, and abdominal pain that might initially be diffuse or upper abdominal.
  • Myocarditis or pericarditis: These conditions can present with chest pain, fever, and systemic symptoms that might be confused with a cold or flu, especially in a young adult.
  • Meningitis: While the headache and nausea might suggest a viral infection, meningitis is a critical diagnosis that must be considered, especially if there's a severe headache, fever, stiff neck, or altered mental status.

• Rare Diagnoses

  • Inflammatory bowel disease (IBD): The gastrointestinal symptoms could, in rare cases, be the initial presentation of IBD, such as Crohn's disease or ulcerative colitis, especially if there's a family history or if symptoms persist despite treatment for more common conditions.
  • Thyroiditis: Subacute thyroiditis can present with systemic symptoms including fever, headache, and gastrointestinal symptoms, although it's less common.
  • Vasculitis: Certain types of vasculitis, like giant cell arteritis (though rare in this age group) or ANCA-associated vasculitis, can present with a wide range of systemic symptoms including those described.