Differential Diagnosis for Stiff Neck and Nausea/Vomiting
Single Most Likely Diagnosis
- Viral Meningitis: This is a common cause of stiff neck (nuchal rigidity) and can be accompanied by nausea and vomiting. The symptoms presented, such as stiff neck for 3 days and current nausea and vomiting, are consistent with the early stages of viral meningitis, which often starts with non-specific symptoms like fever, headache, and stiff neck.
Other Likely Diagnoses
- Bacterial Meningitis: Although less common than viral meningitis, bacterial meningitis is a significant consideration due to its severity and the need for prompt antibiotic treatment. Symptoms can include stiff neck, fever, headache, and nausea/vomiting.
- Gastroenteritis: This condition, often caused by a viral or bacterial infection, can lead to nausea, vomiting, and sometimes stiffness in the neck due to dehydration or muscle strain from prolonged vomiting.
- Food Poisoning: Similar to gastroenteritis, food poisoning can cause severe nausea and vomiting. While less commonly associated with stiff neck, it could potentially cause muscle stiffness due to dehydration or electrolyte imbalances.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A life-threatening condition that requires immediate medical attention. Although it typically presents with a sudden, severe headache, nausea and vomiting can occur, and sometimes patients may report neck stiffness due to irritation of the meninges.
- Encephalitis: Inflammation of the brain tissue, usually caused by viral infections. It can present with a range of symptoms including fever, headache, confusion, and sometimes neck stiffness, along with nausea and vomiting.
- Brain Abscess: A rare but potentially life-threatening condition where an abscess forms in the brain. Symptoms can include headache, fever, nausea, vomiting, and sometimes neck stiffness, especially if the abscess is located near the brainstem or meninges.
Rare Diagnoses
- Tuberculous Meningitis: A form of meningitis caused by Mycobacterium tuberculosis. It's less common in regions with good healthcare but can present with chronic symptoms including headache, stiff neck, and nausea/vomiting.
- Lyme Meningitis: Caused by the bacterium Borrelia burgdorferi, transmitted by tick bites. It can lead to symptoms such as headache, stiff neck, and fever, although nausea and vomiting are less common.
- Neurosyphilis: A complication of syphilis infection that can affect the central nervous system, leading to a variety of symptoms including meningitis, which might present with stiff neck and nausea/vomiting among other neurological symptoms.