Differential Diagnosis for 22-year-old Male with Flulike Symptoms
Single Most Likely Diagnosis
- Viral upper respiratory infection (URI): Given the patient's symptoms of fatigue, fever, chills, nasal congestion, runny nose, and cough, a viral URI is the most likely diagnosis. The absence of shortness of breath, chest pain, or other severe symptoms also supports this diagnosis.
Other Likely Diagnoses
- Influenza: The patient's symptoms and fever are consistent with influenza, especially given the timing (early Sunday morning) and the fact that he was in the emergency room the previous night for seizures, which could be related to a febrile illness.
- Post-seizure infection or complication: The patient's recent seizures could be related to an underlying infection or could have led to an aspiration pneumonia, although he denies shortness of breath or chest pain.
- Exacerbation of underlying conditions: The patient's symptoms could be related to an exacerbation of his underlying conditions, such as a bipolar or PTSD episode, although the presence of fever and other flulike symptoms suggests an infectious etiology.
Do Not Miss Diagnoses
- Pneumonia: Although the patient denies shortness of breath or chest pain, pneumonia is a potentially life-threatening condition that must be considered, especially in a patient with a history of seizures and potential aspiration risk.
- Meningitis or encephalitis: Given the patient's history of seizures and fever, meningitis or encephalitis must be considered, although the absence of severe headache, stiff neck, or altered mental status makes this less likely.
- Endocarditis: The patient's history of a "leaky valve" in his heart increases his risk for endocarditis, which could present with fever, fatigue, and other nonspecific symptoms.
- Status epilepticus or seizure-related complications: The patient's recent seizures could be related to an underlying condition that requires immediate attention, such as status epilepticus or a seizure-related complication.
Rare Diagnoses
- Neuroleptic malignant syndrome (NMS): Although rare, NMS is a life-threatening condition that can occur in patients with a history of psychiatric conditions, such as bipolar disorder, and can present with fever, muscle rigidity, and altered mental status.
- Autism-related complications: The patient's autism diagnosis may increase his risk for certain complications, such as sensory overload or behavioral crises, although these are less likely to present with flulike symptoms.