What is the diagnosis for a 75-year-old woman presenting with an episode of malaise, nausea, vomiting, diarrhea, and diaphoresis, with notable negatives including no chest pain, no abdominal pain, and no vertigo, and a normal emergency room (ER) visit workup, including basic labs and a negative cardiac workup?

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Differential Diagnosis for 75 yo Woman with Episode of Malaise, Nausea, Vomiting, Diarrhea, and Diaphoresis

  • Single Most Likely Diagnosis
    • Viral gastroenteritis: This is a common condition that can cause the symptoms described, especially in the absence of abdominal pain or chest pain. The normal basic labs and negative cardiac workup further support this diagnosis, as they help rule out other potential causes.
  • Other Likely Diagnoses
    • Dehydration: Given the symptoms of vomiting, diarrhea, and diaphoresis, dehydration is a likely diagnosis that needs to be considered and addressed.
    • Medication side effect: The patient's age and potential polypharmacy increase the likelihood of a medication side effect causing her symptoms.
    • Influenza or other viral illness: The symptoms of malaise, nausea, vomiting, and diaphoresis could be indicative of a viral illness such as influenza, especially during certain times of the year.
  • Do Not Miss Diagnoses
    • Septicemia: Although the patient does not have abdominal pain or chest pain, septicemia can present with non-specific symptoms such as malaise, nausea, and vomiting, especially in elderly patients. It is crucial to consider and rule out this potentially life-threatening condition.
    • Pulmonary embolism: Despite the absence of chest pain, pulmonary embolism can present with non-specific symptoms such as nausea, vomiting, and diaphoresis. This diagnosis should be considered, especially given the patient's age and potential risk factors.
    • Cardiac arrhythmia: Although the cardiac workup is negative, cardiac arrhythmias can cause non-specific symptoms such as malaise, nausea, and vomiting. It is essential to consider this diagnosis, especially in elderly patients with potential cardiac risk factors.
  • Rare Diagnoses
    • Adrenal insufficiency: This rare condition can cause non-specific symptoms such as nausea, vomiting, and malaise. Although it is unlikely, it should be considered in the differential diagnosis, especially if other causes are ruled out.
    • Pheochromocytoma: This rare tumor can cause episodes of diaphoresis, nausea, and vomiting, although it is an unlikely cause of the patient's symptoms.
    • Neurological disorders (e.g., autonomic dysfunction): Certain neurological disorders can cause non-specific symptoms such as nausea, vomiting, and diaphoresis. Although rare, these conditions should be considered if other causes are ruled out.

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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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