Differential Diagnosis for a 16-year-old with Sore Throat, Fatigue, and Systemic Symptoms
- Single most likely diagnosis:
- Infectious mononucleosis (mono): This diagnosis is likely due to the patient's symptoms of sore throat, fatigue, body aches, bilateral eye soreness, and swollen lymph nodes. The resolution of the sore throat and the presence of systemic symptoms also support this diagnosis.
- Other Likely diagnoses:
- Viral pharyngitis: The patient's initial sore throat and subsequent resolution of symptoms could be consistent with a viral pharyngitis.
- Influenza: Although the patient denies cough and shortness of breath, the symptoms of body aches, fatigue, and possible fever could be consistent with influenza.
- Acute sinusitis: The patient's symptoms of bilateral eye soreness and fatigue could be related to acute sinusitis, especially given her history of seasonal allergies.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis: Although the patient's symptoms do not strongly suggest meningitis, it is essential to consider this diagnosis due to its potential severity and the presence of fever, headache, and stiff neck (although not explicitly mentioned).
- Sepsis: The patient's possible fever, fatigue, and body aches could be indicative of sepsis, which requires prompt recognition and treatment.
- Lemierre's syndrome: This rare but potentially life-threatening condition is characterized by a sore throat, fever, and swollen lymph nodes, followed by sepsis and thrombophlebitis.
- Rare diagnoses:
- Toxoplasmosis: This parasitic infection can cause swollen lymph nodes, fatigue, and sore throat, although it is less common in immunocompetent individuals.
- Cytomegalovirus (CMV) infection: Similar to infectious mononucleosis, CMV infection can cause systemic symptoms, including sore throat, fatigue, and swollen lymph nodes.
- Lymphoma: Although extremely rare, lymphoma could be considered in the differential diagnosis due to the patient's swollen lymph nodes and systemic symptoms. However, this diagnosis would require further evaluation and testing to confirm.