Differential Diagnosis for Fever with Chills, Loose Stools, and Abdominal Pain
Single Most Likely Diagnosis
- Gastroenteritis: This is the most likely diagnosis given the acute onset of fever, chills, loose stools, and abdominal pain, along with elevated CRP and neutrophilia, which suggest a bacterial infection. Common causes include Salmonella, Shigella, and Campylobacter.
Other Likely Diagnoses
- Food Poisoning: Similar to gastroenteritis, food poisoning can present with sudden onset of symptoms like fever, chills, diarrhea, and abdominal pain, often due to consuming contaminated food.
- Inflammatory Bowel Disease (IBD) Flare: While IBD (such as Crohn's disease or ulcerative colitis) typically has a more chronic course, a flare can present with acute worsening of symptoms including fever, abdominal pain, and changes in bowel habits.
- Appendicitis: Early appendicitis can present with nonspecific symptoms such as fever, abdominal pain, and changes in bowel habits, although the pain often localizes to the right lower quadrant.
Do Not Miss Diagnoses
- Septic Abdominal Conditions (e.g., Perforated Viscus, Abscess): Conditions like a perforated appendix or an intra-abdominal abscess can present with fever, chills, abdominal pain, and elevated inflammatory markers. These are medical emergencies requiring prompt intervention.
- Bacteremia or Sepsis: The presence of fever, chills, and elevated CRP with neutrophilia could indicate bacteremia or sepsis, especially if the patient appears systemically unwell. This would be a life-threatening condition requiring immediate attention.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection (Tropheryma whipplei) that can cause fever, weight loss, diarrhea, and abdominal pain, although it is much less common and typically has a more chronic presentation.
- Intestinal Lymphoma: Although rare, lymphoma involving the intestines can cause a variety of symptoms including fever, weight loss, abdominal pain, and changes in bowel habits, often with a more gradual onset.
- Tropical Infections (e.g., Typhoid Fever): In patients with a travel history to endemic areas, infections like typhoid fever should be considered, presenting with fever, abdominal pain, and sometimes diarrhea.