Differential Diagnosis for Neck Pain, Headache, Fever, High Neutrophil, and CRP 92
- Single Most Likely Diagnosis
- Bacterial Meningitis: The combination of neck pain (suggestive of nuchal rigidity), headache, fever, elevated neutrophil count, and significantly elevated CRP (C-reactive protein) points towards an infectious process, with bacterial meningitis being a leading consideration due to its potential for severe consequences and the need for prompt treatment.
- Other Likely Diagnoses
- Viral Meningitis: Although viral meningitis typically presents with lymphocytic predominance in the cerebrospinal fluid (CSF), early in the course, it can mimic bacterial meningitis, and the clinical presentation can be similar.
- Encephalitis: Inflammation of the brain tissue, which can be caused by viral or bacterial infections, presenting with fever, headache, and altered mental status.
- Osteomyelitis or Discitis: Infections of the bone or intervertebral disc, respectively, which can cause neck pain, fever, and elevated inflammatory markers.
- Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although typically presents with a sudden, severe headache, it's crucial to consider due to its high morbidity and mortality if missed.
- Spinal Epidural Abscess: A collection of pus in the epidural space surrounding the spinal cord, which can cause neck pain, fever, and neurological deficits, requiring urgent intervention.
- Endocarditis: Especially if there's a history of valvular heart disease or intravenous drug use, as it can lead to embolic phenomena and severe complications.
- Rare Diagnoses
- Autoimmune Encephalitis: A group of conditions that occur when the body's immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain.
- Sarcoidosis: A condition in which inflammatory cells form lumps known as granulomas in various parts of the body, including the brain and spinal cord, which can cause a variety of neurological symptoms.
- Behçet's Disease: A rare disorder that causes blood vessel inflammation throughout the body, which can lead to symptoms including headache, fever, and neck pain due to central nervous system involvement.