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.
- Medication-induced Gastroenteritis: The patient took Pepto-Bismol and Imodium, which, although intended to alleviate symptoms, could potentially exacerbate or contribute to gastrointestinal upset in some cases.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although less common in presenting with primarily gastrointestinal symptoms like vomiting and diarrhea, appendicitis can sometimes manifest atypically, especially in adults. It's crucial to consider this diagnosis due to its potential for severe complications if not promptly treated.
- Intestinal Obstruction: This condition can cause severe vomiting and abdominal pain. Although the patient's current symptoms do not strongly suggest obstruction, it's a critical diagnosis not to miss due to its potential for severe outcomes.
- Inflammatory Bowel Disease (IBD) Flare: While less likely given the acute onset, an exacerbation of IBD (e.g., Crohn's disease or ulcerative colitis) could present with similar symptoms and is important to consider, especially if the patient has a history of IBD.
- Rare diagnoses:
- Norovirus or Rotavirus Infection: These viruses can cause severe gastroenteritis, but they are more commonly associated with outbreaks or in specific populations (e.g., norovirus in closed environments like cruise ships).
- Giardiasis: An intestinal infection caused by the parasite Giardia lamblia, which could present with similar symptoms, especially if the patient has been exposed to contaminated water or has recently traveled to endemic areas, though the patient denies recent travel.