Differential Diagnosis for 42-year-old Female with Nausea, Vomiting, and Diarrhea
- Single most likely diagnosis:
- Viral Gastroenteritis: This is the most likely diagnosis given the acute onset of nausea, vomiting, and diarrhea, especially with no recent travel, antibiotic use, or changes in diet. The lack of fever and other systemic symptoms also points towards a viral etiology.
- Other Likely diagnoses:
- Food Poisoning: Although the patient denies a change in diet, food poisoning remains a possibility, especially if she consumed something that was contaminated. The symptoms of food poisoning can be similar to viral gastroenteritis.
- Bacterial Gastroenteritis: This could be considered if the patient had consumed undercooked or contaminated food, although the absence of fever and the lack of recent travel or antibiotic use make this less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although the patient's symptoms are primarily gastrointestinal, appendicitis can sometimes present with nausea, vomiting, and diarrhea, especially if the appendix is located near the bowel. Missing this diagnosis could lead to severe consequences.
- Intestinal Obstruction: This is a surgical emergency that could present with vomiting and abdominal pain. Although less likely given the patient's symptoms, it's crucial not to miss this diagnosis.
- Inflammatory Bowel Disease (IBD) Flare: If the patient has a history of IBD (Crohn's disease or ulcerative colitis), a flare could present with similar symptoms. However, the acute onset and lack of previous diagnosis make this less likely.
- Rare diagnoses:
- Norovirus or Rotavirus Infection: While these are common causes of viral gastroenteritis, they are more typically seen in children or in outbreaks. However, they can affect adults, especially in certain settings like cruise ships or healthcare facilities.
- Giardiasis: This parasitic infection can cause gastrointestinal symptoms but is less common and usually associated with travel or exposure to contaminated water.
- Other infectious causes like Salmonella, Shigella, or E. coli: These bacterial infections can cause similar symptoms but are less likely given the patient's history and the absence of fever or recent travel.