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A 35-year-old man comes to the emergency department with a history of nausea
35 years old | Male
Vignette:
A 35-year-old man comes to the emergency department with a history of nausea, vomiting, and watery diarrhea of 1 day's duration. The patient and his wife have just returned from a Caribbean cruise, and his wife also has mild diarrhea. The patient denies any blood or mucus in the stool. He has chills but no fever. On examination, the patient is afebrile and anicteric, but has dry mucous membranes. His heart rate is 95 beats per minute and BP is 110/70 mmHg. His abdomen is soft and nontender, with hyperactive bowel sounds.
Summary:
nausea | vomiting | watery diarrhea | travel | chills | dry mucous membranes | hyperactive bowel sounds | low bp
Dx:
Viral Gastroenteritis Gastroenteritis Bacterial Gastroenteritis Eosinophilic Gastroenteritis Listerial Gastroenteritis Mucosal Eosinophilic Gastroenteritis Subserosal Eosinophilic Gastroenteritis Muscle Layer Eosinophilic Gastroenteritis
Ref:
https://online.epocrates.com/diseases/20222/Viral-gastroenteritis-in-adults/Common-Vignette
Rank |
Disease |
Weight |
|---|---|---|
| 1 | mucosal Eosinophilic gastroenteritis | 350.0 |
| 2 | Acute Pancreatitis | 348.0 |
| 3 | Bacterial gastroenteritis | 348.0 |
| 4 | Viral Gastroenteritis | 336.0 |
| 5 | Listerial gastroenteritis | 330.0 |
| 6 | Salmonella infection | 318.0 |
| 7 | Intestinal Obstruction | 303.0 |
| 8 | Non-cholera Vibrio infections | 293.0 |
| 9 | Acute pyelonephritis in adults | 284.0 |
| 10 | Muscle Layer Eosinophilic gastroenteritis | 270.0 |
| 11 | Foodborne E coli infection | 266.0 |
| 12 | Gastric Outlet Obstruction | 254.0 |
| 13 | Travelers diarrhea | 253.0 |
| 14 | Gallstone pancreatitis | 249.0 |
| 15 | Brucellosis | 240.0 |
| 16 | Cholera | 240.0 |
| 17 | Migraine headache in adults | 236.0 |
| 18 | Hereditary Angioedema | 235.0 |
| 19 | Gastroenteritis | 233.0 |
| 20 | Food poisoning | 232.0 |
| 21 | Gastroparesis | 230.0 |
| 22 | Acute perforated appendicitis | 230.0 |
| 23 | Pyogenic Liver Abscess | 227.0 |
| 24 | Giardiasis | 227.0 |
| 25 | subserosal eosinophilic gastroenteritis | 218.0 |
| 26 | Eosinophilic gastroenteritis | 218.0 |
| 27 | Klebsiella pneumoniae liver abscess | 217.0 |
| 28 | Acute fatty liver of pregnancy | 216.0 |
| 29 | Anaphylaxis | 204.0 |
| 30 | Rocky Mountain spotted fever | 204.0 |
| 31 | Acute Appendicitis | 198.0 |
| 32 | Pyelonephritis | 198.0 |
| 33 | Addison Disease | 196.0 |
| 34 | Acute intermittent porphyria | 192.0 |
| 35 | Malaria | 189.0 |
| 36 | Intussusception | 186.0 |
| 37 | Diabetic Ketoacidosis | 186.0 |
| 38 | Hiatus hernia | 181.0 |
| 39 | Anthrax | 180.0 |
| 40 | pancreatic cancer | 177.0 |
| 41 | Alcoholic Liver Disease | 169.0 |
| 42 | Spontaneous bacterial peritonitis | 169.0 |
| 43 | Gallbladder cancer | 168.0 |
| 44 | Intestinal Pseudo Obstruction | 167.0 |
| 45 | Ileus | 167.0 |
| 46 | Hemolytic uremic syndrome | 167.0 |
| 47 | Type 1 Diabetes mellitus | 163.0 |
| 48 | Ulcerative Colitis | 162.0 |
| 49 | Short bowel syndrome | 159.0 |
| 50 | Mesenteric ischemia | 157.0 |
| 51 | Acute Cholecystitis | 157.0 |
| 52 | Emphysematous cholecystitis | 157.0 |
| 53 | Motion Sickness | 156.0 |
| 54 | Ovarian Torsion | 156.0 |
| 55 | Irritable Bowel Syndrome | 154.0 |
| 56 | Campylobacter infection | 153.0 |
| 57 | Crohn Disease | 152.0 |
| 58 | Papilledema | 152.0 |
| 59 | Clostridium difficile infection | 152.0 |
| 60 | Ovarian Hyperstimulation Syndrome | 151.0 |
| 61 | Intra-abdominal abscess | 151.0 |
| 62 | Aseptic meningitis | 150.0 |
| 63 | Acute viral meningitis | 149.0 |
| 64 | Acute peptic ulcer | 148.0 |
| 65 | Gallbladder Dyskinesia | 146.0 |
| 66 | pancreatic SOD | 146.0 |
| 67 | Hypercalcemia | 146.0 |
| 68 | Acute Cholangitis | 146.0 |
| 69 | Adrenal crisis | 144.0 |
| 70 | Primary sclerosing cholangitis | 143.0 |
| 71 | Foreign body ingestion | 142.0 |
| 72 | Secondary Peritonitis | 141.0 |
| 73 | Thrombotic thrombocytopenic purpura | 140.0 |
| 74 | Choledocholithiasis | 139.0 |
| 75 | Acute bacterial meningitis in children | 139.0 |
| 76 | Ruptured Tuboovarian abscess | 139.0 |
| 77 | Sunburn | 138.0 |
| 78 | Meckel diverticulum | 138.0 |
| 79 | Intestinal Entamoeba histolytica amebiasis | 138.0 |
| 80 | Chronic bacterial prostatitis | 137.0 |
| 81 | Acute Clonorchiasis | 135.0 |
| 82 | Toxic Megacolon | 134.0 |
| 83 | ST-elevation myocardial infarction | 133.0 |
| 84 | Diverticulitis | 130.0 |
| 85 | Peritoneal dialysis associated peritonitis | 130.0 |
| 86 | Sphincter of Oddi Dysfunction | 130.0 |
| 87 | Alcoholic Liver Cirrhosis | 130.0 |
| 88 | biliary SOD | 130.0 |
| 89 | Acute Hepatitis | 130.0 |
| 90 | Systemic sclerosis | 130.0 |
| 91 | Acetaminophen overdose | 130.0 |
| 92 | Acute Liver Failure | 128.0 |
| 93 | Lactose intolerance | 128.0 |
| 94 | Acute bacterial meningitis in adults | 128.0 |
| 95 | Graves Disease | 128.0 |
| 96 | Typhoid infection | 124.0 |
| 97 | Non-ST-elevation myocardial infarction | 121.0 |
| 98 | Type 2 Diabetes mellitus | 120.0 |
| 99 | Mallory-Weiss syndrome | 120.0 |
| 100 | Esophagitis | 119.0 |
| 101 | Ovarian Cancer | 118.0 |
| 102 | Labyrinthitis | 118.0 |
| 103 | Ovarian and fallopian tube torsion | 117.0 |
| 104 | Henoch-Schonlein purpura | 117.0 |
| 105 | Gallstones | 116.0 |
| 106 | Gastritis | 116.0 |
| 107 | Non-small cell lung cancer | 116.0 |
| 108 | Autoimmune hepatitis | 111.0 |
| 109 | Renal and perinephric abscess | 111.0 |
| 110 | Unstable angina | 110.0 |
| 111 | Angle Closure Glaucoma | 109.0 |
| 112 | Pancreatic Pseudocyst | 108.0 |
| 113 | Autosomal Dominant Polycystic Kidney Disease | 108.0 |
| 114 | Sigmoid volvulus | 107.0 |
| 115 | Infectious mononucleosis | 106.0 |
| 116 | Amebic Liver Abscess | 106.0 |
| 117 | Acute peritonitis | 106.0 |
| 118 | Migraine | 104.0 |
| 119 | Inguinal hernia | 103.0 |
| 120 | Amphetamine use disorder | 103.0 |
| 121 | Kawasaki disease | 103.0 |
| 122 | Gastric cancer | 102.0 |
| 123 | Pheochromocytoma | 102.0 |
| 124 | End Stage Renal Disease | 100.0 |
| 125 | Milk-alkali syndrome | 100.0 |
| 126 | Common cutaneous drug reactions | 100.0 |
| 127 | Subdural hematoma | 100.0 |
| 128 | Acute Milk-alkali syndrome | 100.0 |
| 129 | Chronic Milk-alkali syndrome | 100.0 |
| 130 | Liver disease | 99.0 |
| 131 | Annular pancreas | 99.0 |
| 132 | Kidney stones | 99.0 |
| 133 | Biliary cirrhosis | 98.0 |
| 134 | Primary biliary cirrhosis | 98.0 |
| 135 | Bacterial pharyngitis | 98.0 |
| 136 | Pneumonia | 97.0 |
| 137 | Chronic Pancreatitis | 96.0 |
| 138 | Adrenal Suppression | 96.0 |
| 139 | Polyarteritis nodosa | 95.0 |
| 140 | Systemic lupus erythematosus | 95.0 |
| 141 | Sialadenitis | 94.0 |
| 142 | Choledochal Cyst | 93.0 |
| 143 | Panic disorder in adults | 93.0 |
| 144 | Diabetes Mellitus | 92.0 |
| 145 | Chronic pyelonephritis | 91.0 |
| 146 | biliary colic | 90.0 |
| 147 | Acute heart failure | 90.0 |
| 148 | Gout | 90.0 |
| 149 | Hypertriglyceridemia | 89.0 |
| 150 | Sarcoidosis | 88.0 |
| 151 | Stevens-Johnson syndrome | 88.0 |
| 152 | Alcoholic Fatty Liver | 87.0 |
| 153 | Acute disseminated encephalomyelitis | 87.0 |
| 154 | Tuberculous Peritonitis | 87.0 |
| 155 | Duodenal Ulcer | 86.0 |
| 156 | Gastric Ulcer | 86.0 |
| 157 | Cryptococcosis | 86.0 |
| 158 | Hyperthyroidism | 85.0 |
| 159 | Meniere disease | 84.0 |
| 160 | Liver Cirrhosis | 83.0 |
| 161 | Shigellosis | 83.0 |
| 162 | Alcoholic hepatitis | 82.0 |
| 163 | Lung Cancer | 82.0 |
| 164 | Fungal meningitis | 82.0 |
| 165 | Insect bites and stings | 78.0 |
| 166 | Rumination Syndrome | 77.0 |
| 167 | Heparin-induced thrombocytopenia | 77.0 |
| 168 | Animal bites | 76.0 |
| 169 | Peptic Ulcer | 75.0 |
| 170 | Diabetic Kidney Disease | 75.0 |
| 171 | Acute otitis media | 75.0 |
| 172 | Tuboovarian abscess | 75.0 |
| 173 | Dyspepsia | 74.0 |
| 174 | Eclampsia | 74.0 |
| 175 | Hyperosmolar Hyperglycemic state | 73.0 |
| 176 | Ischemic stroke | 73.0 |
| 177 | Disseminated intravascular coagulation | 73.0 |
| 178 | COVID19 | 72.0 |
| 179 | Chronic Renal vein thrombosis | 72.0 |
| 180 | Hyperparathyroidism | 71.0 |
| 181 | Chronic meningitis | 70.0 |
| 182 | Wilson disease | 68.0 |
| 183 | chronic acalculous cholecystitis | 68.0 |
| 184 | Hypoparathyroidism | 66.0 |
| 185 | Acute atrial fibrillation | 66.0 |
| 186 | Cellulitis | 66.0 |
| 187 | Hepatocellular carcinoma | 65.0 |
| 188 | Pancreatitis | 65.0 |
| 189 | Liver Abscess | 65.0 |
| 190 | Splenic Infarction | 64.0 |
| 191 | Chronic heart failure | 64.0 |
| 192 | anterior ischemic optic neuropathy | 63.0 |
| 193 | Primary Myelofibrosis | 62.0 |
| 194 | Acute bacterial meningitis in neonates | 62.0 |
| 195 | Hemorrhagic stroke | 61.0 |
| 196 | Ectopic Pregnancy | 60.0 |
| 197 | Ruptured ectopic pregnancy | 60.0 |
| 198 | Analgesic nephropathy | 60.0 |
| 199 | Hyperglycemia | 60.0 |
| 200 | Renal vein thrombosis | 60.0 |
| 201 | Acute Renal vein thrombosis | 60.0 |
| 202 | Aortic Dissection | 59.0 |
| 203 | Oral candidiasis | 59.0 |
| 204 | Vulvovaginal candidiasis | 59.0 |
| 205 | Oropharyngeal and esophageal candidiasis | 59.0 |
| 206 | Candida Balanitis | 59.0 |
| 207 | Candidal intertrigo | 59.0 |
| 208 | posteriorischemic optic neuropathy | 58.0 |
| 209 | Acute Mitral regurgitation | 58.0 |
| 210 | Prinzmetal angina | 57.0 |
| 211 | Guillain-Barre syndrome | 57.0 |
| 212 | Acute pericarditis | 55.0 |
| 213 | Diabetic Neuropathy | 55.0 |
| 214 | Influenza | 55.0 |
| 215 | Gastrointestinal Hemorrhage | 55.0 |
| 216 | Lower gastrointestinal hemorrhage | 55.0 |
| 217 | Upper gastrointestinal hemorrhage | 55.0 |
| 218 | Zollinger-Ellison Syndrome | 54.0 |
| 219 | Peritonitis | 54.0 |
| 220 | Celiac Disease | 53.0 |
| 221 | Intraperitoneal bleeding | 53.0 |
| 222 | Tetanus | 53.0 |
| 223 | Stable ischemic heart disease | 52.0 |
| 224 | Intestinal malrotation | 52.0 |
| 225 | Diabetic Amyotrophy | 52.0 |
| 226 | Extraintestinal Entamoeba histolytica amebiasis | 52.0 |
| 227 | Multiple endocrine neoplasia 2A | 51.0 |
| 228 | Endometritis | 51.0 |
| 229 | Menopause | 51.0 |
| 230 | Breast Cancer | 50.0 |
| 231 | Cushing syndrome | 50.0 |
| 232 | Acute Bacterial Prostatitis | 50.0 |
| 233 | Stable angina | 49.0 |
| 234 | Multiple Myeloma | 49.0 |
| 235 | Hypogammaglobulinemia | 49.0 |
| 236 | Abdominal compartment syndrome | 49.0 |
| 237 | Colorectal cancer | 48.0 |
| 238 | Glomerulonephritis | 48.0 |
| 239 | Familial Mediterranean fever | 48.0 |
| 240 | Leiomyomas | 47.0 |
| 241 | Endometrial cancer | 47.0 |
| 242 | Multiple endocrine neoplasia 2B | 47.0 |
| 243 | Autosomal Recessive Polycystic Kidney Disease | 46.0 |
| 244 | Amyloidosis | 46.0 |
| 245 | Herpes zoster | 46.0 |
| 246 | Atypical pneumonia | 46.0 |
| 247 | Chronic Hepatitis | 45.0 |
| 248 | Pulmonary Embolism | 45.0 |
| 249 | Amebiasis | 45.0 |
| 250 | Cholangitis | 45.0 |
| 251 | Familial adenomatous polyposis syndrome | 44.0 |
| 252 | Peutz-Jeghers Syndrome | 44.0 |
| 253 | Anal Fissure | 44.0 |
| 254 | Ascites | 43.0 |
| 255 | Acalculous Cholecystitis | 41.0 |
| 256 | Acute Lymphoblastic leukemia in children | 41.0 |
| 257 | Umbilical hernia | 41.0 |
| 258 | Stroke | 41.0 |
| 259 | Acute Myeloid Leukemia in children | 41.0 |
| 260 | Acute Cystitis(Men) | 40.0 |
| 261 | Urinary tract infection | 40.0 |
| 262 | Cystitis | 40.0 |
| 263 | Cholangiocarcinoma | 39.0 |
| 264 | Rheumatoid Arthritis | 39.0 |
| 265 | Abetalipoproteinemia | 39.0 |
| 266 | Granulomatosis with polyangiitis | 39.0 |
| 267 | Deep venous thrombosis | 39.0 |
| 268 | Gastric Volvulus | 38.0 |
| 269 | Mitral Stenosis | 38.0 |
| 270 | Chronic Clonorchiasis | 37.0 |
| 271 | Psychogenic polydipsia | 37.0 |
| 272 | Toxic thyroid adenoma | 37.0 |
| 273 | Inflammatory Bowel Diseases | 36.0 |
| 274 | Malt lymphoma | 36.0 |
| 275 | Periorbital and orbital cellulitis | 36.0 |
| 276 | Psoas Abscess | 36.0 |
| 277 | Autoimmune Pancreatitis | 35.0 |
| 278 | Chronic Cholecystitis | 35.0 |
| 279 | Churg-Strauss Syndrome | 35.0 |
| 280 | Hypothyroidism | 34.0 |
| 281 | Intrahepatic cholestasis of pregnancy | 34.0 |
| 282 | Chronic pelvic pain in women | 34.0 |
| 283 | Osteomyelitis | 34.0 |
| 284 | Osteoporosis | 33.0 |
| 285 | Hereditary hemochromatosis | 33.0 |
| 286 | Anaplastic thyroid cancer | 33.0 |
| 287 | Acute Myeloid Leukemia in adults | 33.0 |
| 288 | Cystic Fibrosis | 31.0 |
| 289 | Gilbert syndrome | 31.0 |
| 290 | Chronic Myeloid Leukemia | 31.0 |
| 291 | Tinnitus | 31.0 |
| 292 | Pelvic inflammatory disease | 31.0 |
| 293 | Acute pelvic inflammatory disease | 31.0 |
| 294 | Epiploic appendagitis | 30.0 |
| 295 | Achalasia | 30.0 |
| 296 | Acute bacterial rhinosinusitis | 30.0 |
| 297 | Drowning | 30.0 |
| 298 | Chronic atrial fibrillation | 30.0 |
| 299 | Atopic dermatitis | 30.0 |
| 300 | Premature labor | 30.0 |
| 301 | Gastroesophageal reflux disease | 29.0 |
| 302 | Hepatorenal Syndrome | 29.0 |
| 303 | Urinary Tract Obstruction | 29.0 |
| 304 | Aortic stenosis | 29.0 |
| 305 | Acute respiratory failure | 28.0 |
| 306 | Ischemic optic neuropathy | 28.0 |
| 307 | Graves ophthalmopathy | 27.0 |
| 308 | Paraneoplastic Syndromes | 25.0 |
| 309 | Adrenocortical carcinoma | 25.0 |
| 310 | Bed bugs | 25.0 |
| 311 | Aortic coarctation | 25.0 |
| 312 | Chronic Kidney Diseases | 25.0 |
| 313 | Prolactinoma | 25.0 |
| 314 | Abnormal uterine bleeding | 25.0 |
| 315 | Candidiasis | 25.0 |
| 316 | Acromegaly | 22.0 |
| 317 | STI HIV Pharyngitis | 22.0 |
| 318 | Central diabetes insipidus | 22.0 |
| 319 | Nephrogenic diabetes insipidus | 22.0 |
| 320 | Testicular cancer | 20.0 |
| 321 | Acne fulminans | 20.0 |
| 322 | Priapism | 20.0 |
| 323 | Oropharyngeal cancer | 20.0 |
| 324 | Angiodysplasia of the colon | 20.0 |
| 325 | Hyperprolactinemia | 19.0 |
| 326 | Biliary cyst | 19.0 |
| 327 | Secondary hyperparathyroidism | 18.0 |
| 328 | Medullary thyroid cancer | 18.0 |
| 329 | Pressure ulcer | 18.0 |
| 330 | Acute cervical spine trauma | 18.0 |
| 331 | Common cold(adults) | 17.0 |
| 332 | Obstructive Sleep Apnea | 16.0 |
| 333 | Ankylosing spondylitis | 16.0 |
| 334 | Gallbladder Empyema | 16.0 |
| 335 | Renal Cell Carcinoma | 15.0 |
| 336 | Splenic abscess | 15.0 |
| 337 | Epididymo-orchitis | 15.0 |
| 338 | Fibromyalgia | 14.0 |
| 339 | Preeclampsia | 14.0 |
| 340 | Middle East respiratory syndrome | 14.0 |
| 341 | Endometriosis | 14.0 |
| 342 | Psoriasis | 14.0 |
| 343 | Mitral Valve Prolapse | 14.0 |
| 344 | Anemia of chronic disease | 12.0 |
| 345 | Allergic rhinitis | 12.0 |
| 346 | Chronic Mitral regurgitation | 12.0 |
| 347 | Acute Lymphocytic Leukemia in Adults | 11.0 |
| 348 | Laryngeal Cancer | 11.0 |
| 349 | Chronic Lymphocytic Leukemia | 10.0 |
| 350 | Premenstrual syndrome | 10.0 |
| 351 | Toxic multinodular goiter | 10.0 |
| 352 | Von willebrand disease | 10.0 |
| 353 | Acute Bronchitis | 9.0 |
| 354 | Dacryocystitis | 9.0 |
| 355 | Clonorchiasis | 8.0 |
| 356 | Common cold(children) | 8.0 |
| 357 | Ruptured ovarian cyst | 8.0 |
| 358 | Immune thrombocytopenia | 6.0 |
| 359 | Asthma | 6.0 |
| 360 | Hyperaldosteronism | 6.0 |
| 361 | Primary ciliary dyskinesia | 5.0 |
| 362 | Kartagener syndrome | 5.0 |
| 363 | Limited cutaneous systemic sclerosis | 5.0 |
| 364 | Non-alcoholic Fatty Liver Disease | 5.0 |
| 365 | Budd Chiari Syndrome | 4.0 |
| 366 | Conjunctivitis | 0.0 |
| 367 | Epidemic keratoconjunctivitis | 0.0 |
| 368 | Bacterial conjunctivitis | 0.0 |
| 369 | Viral conjunctivitis | 0.0 |
| 370 | Allergic conjunctivitis | 0.0 |
| 371 | Ligneous conjunctivitis | 0.0 |
| 372 | Vernal keratoconjunctivitis | 0.0 |
| 373 | Atopic keratoconjunctivitis | 0.0 |
| 374 | Noninfectious nonallergic conjunctivitis | 0.0 |
| 375 | Acute epididymitis | 0.0 |
| 376 | Recurrent aphthous stomatitis | 0.0 |
| 377 | Discogenic low back pain | 0.0 |
| 378 | Transient ischemic attack | 0.0 |
| 379 | Zenker diverticulum | 0.0 |
| 380 | Acute Cystitis(Women) | 0.0 |