What is the differential diagnosis for a 13-year-old patient presenting with cough, intermittent nausea, diarrhea, and fever for 4 days, with negative in-office tests for COVID-19 (Coronavirus Disease 2019) and influenza?

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Differential Diagnosis for 13 Y.O. Patient

Single Most Likely Diagnosis

  • Viral Gastroenteritis: This is the most likely diagnosis given the symptoms of cough, nausea, diarrhea, and fever. The negative COVID-19 and influenza tests reduce the likelihood of these specific viral infections, but the patient could still have another type of viral gastroenteritis, such as norovirus or rotavirus.

Other Likely Diagnoses

  • Acute Bronchitis: The cough and fever could suggest an acute bronchitis, possibly caused by a viral or bacterial infection.
  • Common Cold: Although the patient has gastrointestinal symptoms, the cough and fever could also be consistent with a common cold, especially if the gastrointestinal symptoms are mild.
  • Food Poisoning: The nausea, diarrhea, and fever could be indicative of food poisoning, which is a common cause of gastrointestinal symptoms in children.

Do Not Miss Diagnoses

  • Appendicitis: Although less likely, appendicitis is a serious condition that requires prompt surgical intervention. The nausea, fever, and abdominal pain (if present) could be indicative of appendicitis.
  • Pneumonia: The cough and fever could suggest pneumonia, which is a serious infection that requires prompt antibiotic treatment.
  • Inflammatory Bowel Disease (IBD): The gastrointestinal symptoms could be indicative of IBD, such as Crohn's disease or ulcerative colitis, which require prompt medical attention.

Rare Diagnoses

  • Tuberculosis (TB): Although rare in children, TB is a serious infection that requires prompt treatment. The cough and fever could be indicative of TB, especially if the patient has been exposed to someone with TB.
  • Cystic Fibrosis: The recurrent respiratory and gastrointestinal symptoms could be indicative of cystic fibrosis, a genetic disorder that requires prompt medical attention.
  • HUS (Hemolytic Uremic Syndrome): The diarrhea and fever could be indicative of HUS, a rare but serious condition that requires prompt medical attention.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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