Differential Diagnosis for Central American Disease with Fever, Diaphoresis, Thrombocytopenia, Elevated LDH, and Atypical Lymphocytes on CBC
- Single Most Likely Diagnosis
- Dengue Fever: This is a common disease in Central America, characterized by fever, diaphoresis, thrombocytopenia, and elevated liver enzymes, including LDH. The presence of atypical lymphocytes on CBC can also be seen in dengue fever due to the immune response to the virus.
- Other Likely Diagnoses
- Chikungunya: Similar to dengue fever, chikungunya is prevalent in Central America and can cause fever, thrombocytopenia, and elevated LDH. Atypical lymphocytes may be present due to the viral infection.
- Zika Virus: Although less commonly associated with severe thrombocytopenia and elevated LDH compared to dengue, Zika virus infection can present with fever, diaphoresis, and atypical lymphocytes.
- Do Not Miss Diagnoses
- Malaria: While less likely given the specific combination of symptoms and lab findings, malaria is a critical diagnosis to consider due to its high mortality rate if untreated. It can cause fever, diaphoresis, thrombocytopenia, and elevated LDH, especially in severe cases.
- Leptospirosis: This bacterial infection can present with a wide range of symptoms, including fever, diaphoresis, and thrombocytopenia. Elevated LDH and atypical lymphocytes can be seen in severe cases, making it a diagnosis that should not be missed due to its potential for severe outcomes.
- Rare Diagnoses
- Ehrlichiosis/Anaplasmosis: These tick-borne illnesses can cause fever, thrombocytopenia, and elevated liver enzymes, including LDH. Atypical lymphocytes may be present, but they are less common in Central America compared to other regions.
- Hemorrhagic Fever (e.g., Venezuelan Hemorrhagic Fever): Although rare and more geographically restricted, these viral hemorrhagic fevers can present with severe symptoms, including fever, diaphoresis, thrombocytopenia, and elevated LDH, making them important to consider in the differential diagnosis due to their high mortality rates.