Differential Diagnosis for WBC 14.0, CRP 11.7 in 28 week pregnant female with abdominal pain
- The patient's presentation of abdominal pain, elevated white blood cell count (WBC), and elevated C-reactive protein (CRP) at 28 weeks of gestation is concerning for several potential diagnoses.
Single most likely diagnosis
- Preterm labor with chorioamnionitis: This condition is a leading cause of maternal and fetal morbidity and mortality. The elevated WBC and CRP are indicative of an infectious process, and abdominal pain is a common symptom of chorioamnionitis.
Other Likely diagnoses
- Pyelonephritis: Pregnant women are at increased risk of developing pyelonephritis due to urinary stasis and ureteral dilation. The elevated WBC and CRP, along with abdominal pain, are consistent with this diagnosis.
- Appendicitis: Although less common during pregnancy, appendicitis can occur and may present with abdominal pain, elevated WBC, and CRP.
- Preeclampsia with HELLP syndrome: This condition can cause abdominal pain, elevated WBC, and CRP, although it is typically associated with hypertension and proteinuria.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Placental abruption: This condition can cause abdominal pain, elevated WBC, and CRP, and is a medical emergency that requires prompt attention.
- Uterine rupture: Although rare, uterine rupture can occur in pregnant women, especially those with a history of uterine surgery or trauma.
- Ovarian torsion: This condition can cause severe abdominal pain and may be associated with elevated WBC and CRP.
Rare diagnoses
- Hepatitis: Although less common, hepatitis can cause abdominal pain, elevated WBC, and CRP in pregnant women.
- Pancreatitis: This condition can cause abdominal pain, elevated WBC, and CRP, although it is relatively rare during pregnancy.