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Sep 13, 2015
Hi. I'm currently a med student who just entered clinical years, and I'm trying to figure out what has happened on my friend. I got puzzled making a diagnosis and I hope you may help me with it. Thankyou!
She presented with two days of mild watery diarrhea, followed by cough and sneeze. She's afebrile (or in any case, it's so mild that she didn't notice it ). And later together with the respiratory tract symptoms, she also found little erythematous papules over her upper lips.

My question is :
Can I still say it is flu since she presented with diarrhea as the first symptoms, or it is in fact gastroenteritis? How can I differentiate between two?
And do you think it is bacterial or viral infection?

Look forwards to hearing from any of you.

Doctor Bob

Fellowship aPD
10+ Year Member
Feb 12, 2009
Attending Physician
It sounds like end-stage leimyosarcoma; or atypical dengue. Perhaps tufting's enteropathy.

But seriously, we here at SDN don't give medical advice, or serve as an online diagnosis source. It's a medicolegal thing.

But we can talk about one of your subquestions...

How can I differentiate between two?
That's a pretty common diagnostic dilemma. You have a patient with general URI/GI symptoms, non-specific findings, and otherwise looks well. After ruling out dangerous life threatening causes, how do you figure out which virus is the cause?
A lot of times you don't need to. The treatment of viral gastro and viral flu (after the first 48hours) and the millions of other URI/GI viruses is the same. Supportive care, keep hydrated, carry on. Sure, you could do a multiplex or flu swab (or whatever is your hospital's virus panel du jour) but so what. You'll still do the same thing. We try to speciate the virus on patients in the ICU because a lot of the treatment recommendations get thrown out the window in critically ill patients.
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No Meat, No Treat
Staff member
10+ Year Member
Mar 6, 2005
Attending Physician
SDN is not for medical advice. Closing.
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