Differential Diagnosis for Fever and Pain
The differential diagnosis for a patient presenting with fever and pain can be organized into the following categories:
- Single Most Likely Diagnosis
- Acute Pyelonephritis: This is a common condition that presents with fever, flank pain, and urinary symptoms. The combination of fever and pain, particularly if localized to the flank or abdomen, makes pyelonephritis a leading consideration.
- Other Likely Diagnoses
- Appendicitis: Characterized by fever, abdominal pain (often starting around the navel and then moving to the lower right abdomen), and other symptoms like nausea and vomiting. It's a common cause of acute abdominal pain.
- Diverticulitis: Inflammation of the diverticula in the digestive tract, typically presenting with fever, abdominal pain (usually on the lower left side), and changes in bowel habits.
- Cholecystitis: Inflammation of the gallbladder, often due to gallstones, presenting with fever, right upper quadrant abdominal pain, and sometimes jaundice.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: A pregnancy in which a fertilized egg implants outside the uterus, often presenting with abdominal pain and fever, among other symptoms. It's critical to consider this in women of childbearing age due to its high mortality rate if not promptly treated.
- Ruptured Aortic Aneurysm: Although less common, this condition presents with severe abdominal or back pain and can be associated with fever if there's an infectious component. It's a medical emergency.
- Septic Arthritis: A joint infection that can present with fever, joint pain, and swelling. Prompt diagnosis and treatment are crucial to prevent long-term joint damage.
- Rare Diagnoses
- Familial Mediterranean Fever: A genetic disorder that causes recurrent episodes of fever and painful inflammation, often in the abdomen, chest, or joints.
- Sickle Cell Crisis: In patients with sickle cell disease, crises can occur due to various triggers, leading to fever and severe pain episodes, typically in the bones, joints, or abdomen.
- Ovarian Torsion: A condition where the ovary twists around its ligaments, cutting off blood supply, presenting with severe pelvic pain and possibly fever. It's a rare but serious condition requiring immediate medical attention.
Each of these diagnoses has distinct features, but the presence of fever and pain necessitates a thorough evaluation to determine the underlying cause and provide appropriate treatment.