Differential Diagnosis for a 4 x 3.4cm Rim Enhancing Abscess Complex Fluid Collection in the Right Axilla
- Single most likely diagnosis
- Soft tissue abscess: This is the most likely diagnosis given the description of a rim-enhancing abscess with complex fluid collection in the right axilla. The rim enhancement is characteristic of an abscess, which is a collection of pus that has built up within the tissue.
- Other Likely diagnoses
- Infected seroma or hematoma: These can present similarly to an abscess, especially if there has been recent trauma or surgery in the area. Infection of a seroma (a collection of fluid that can occur after surgery) or hematoma (a collection of blood outside of blood vessels) could lead to symptoms and imaging findings similar to those of an abscess.
- Necrotic tumor: Although less common, a necrotic tumor in the axilla could potentially present with rim enhancement and complex fluid collection on imaging, mimicking an abscess.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cat-scratch disease with abscess formation: This is an infection caused by Bartonella henselae, typically transmitted through a cat scratch or bite. It can lead to lymphadenopathy (swollen lymph nodes) and abscess formation, which could be located in the axilla.
- Tuberculous abscess: Tuberculosis (TB) can manifest in various forms, including as an abscess in soft tissues. Although less common in many parts of the world, TB is a critical diagnosis not to miss due to its public health implications and the need for specific treatment.
- Actinomycosis: This is a rare chronic bacterial infection that can cause abscesses and sinus tracts in soft tissues. It's essential to consider this diagnosis to ensure appropriate antibiotic treatment.
- Rare diagnoses
- Hydatid cyst: Caused by the Echinococcus parasite, hydatid cysts can rarely occur in soft tissues and might present with complex fluid collections. However, this would be an unusual location and presentation.
- Mycetoma: A chronic granulomatous infection of the skin and subcutaneous tissue caused by fungi or bacteria, which could potentially present with abscess-like features, although it's more commonly associated with a draining sinus tract.
- Brucellar abscess: Brucellosis is a zoonotic infection that can rarely cause abscesses in various parts of the body, including soft tissues. It's essential to consider this in individuals with exposure to animals or their products.