What is the cause of a 2-day history of right-sided swollen lymph nodes (lymphadenopathy) with associated pain upon swallowing (odynophagia), but no throat soreness?

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Differential Diagnosis for 2-Day Right Side Swollen Glands

  • Single most likely diagnosis
    • Viral pharyngitis: The patient's symptoms of swollen glands and pain upon swallowing, without a sore throat, could be indicative of a viral infection affecting the lymph nodes in the neck, which is a common and likely cause.
  • Other Likely diagnoses
    • Bacterial pharyngitis: Although the throat is not sore, bacterial infections like streptococcal pharyngitis can cause swollen lymph nodes and discomfort, making it a plausible diagnosis.
    • Mononucleosis: Caused by the Epstein-Barr virus, this condition often presents with swollen lymph nodes, particularly in the neck, and can lead to discomfort when swallowing.
    • Reactive lymphadenitis: This is an inflammatory reaction in the lymph nodes, often in response to an infection elsewhere in the body, which could explain the swollen and painful glands.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Malignancy (lymphoma): Although rare, lymphoma can present with swollen lymph nodes, and it is crucial to consider this diagnosis to ensure timely treatment if present.
    • Abscess (peritonsillar or retropharyngeal): These can cause severe pain and swelling, and if not promptly treated, can lead to serious complications, including airway obstruction.
    • Tuberculosis: A less common cause of lymphadenitis, especially in areas with high prevalence, which requires specific treatment and can have significant consequences if missed.
  • Rare diagnoses
    • Sjögren's syndrome: An autoimmune disorder that can cause swollen lymph nodes and salivary gland enlargement, though it's less likely given the acute presentation.
    • Cat-scratch disease: Caused by Bartonella henselae, transmitted through cat scratches, which can lead to swollen and painful lymph nodes, particularly in the neck.
    • Toxoplasmosis: A parasitic infection that can cause lymphadenopathy, though it's more commonly associated with other systemic symptoms.

Professional Medical Disclaimer

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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