Differential Diagnosis for a 14-Year-Old Female with Headache, Fever, Abdominal Pain, and Vomiting
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is a common condition in adolescents, characterized by inflammation of the stomach and intestines, often due to a viral infection. Symptoms include headache, fever, abdominal pain, and vomiting, which match the patient's presentation.
Other Likely Diagnoses
- Appendicitis: Although more commonly associated with severe abdominal pain, appendicitis can present with a variety of symptoms including fever, headache, and vomiting, especially in the early stages.
- Urinary Tract Infection (UTI): UTIs can cause abdominal pain, fever, and vomiting. The headache could be related to the infection or dehydration from vomiting.
- Food Poisoning: Similar to viral gastroenteritis, food poisoning can cause abdominal pain, fever, headache, and vomiting due to the ingestion of contaminated food.
Do Not Miss Diagnoses
- Meningitis: Although less likely, meningitis is a critical diagnosis that must be considered due to its potential for severe morbidity and mortality. It can present with headache, fever, and vomiting, and abdominal pain can occasionally be a symptom.
- Ovarian Torsion: This is a surgical emergency that can cause severe abdominal pain, vomiting, and sometimes fever. It's less common but critical not to miss.
- Ectopic Pregnancy: In sexually active females, ectopic pregnancy must be considered, especially if there's a possibility of pregnancy. Symptoms can include abdominal pain, vomiting, and sometimes headache and fever.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic abdominal pain, fever, and changes in bowel habits, but they are less likely to cause acute headache and vomiting.
- Hepatitis: Although rare in adolescents without specific risk factors, hepatitis can cause abdominal pain, fever, and vomiting, along with jaundice and other symptoms.
- Pancreatitis: This condition can cause severe abdominal pain, vomiting, and sometimes fever. It's less common in adolescents without specific risk factors like gallstones or certain medications.