Differential Diagnosis for Neck Swelling
Single Most Likely Diagnosis
- Submandibular abscess or cellulitis: The presence of neck swelling in the right submandibular area, elevated CRP (77), and ESR (33) suggests an infectious or inflammatory process. The normal white count does not rule out an abscess or cellulitis, as these conditions can sometimes present with a normal or only slightly elevated white blood cell count.
Other Likely Diagnoses
- Dental infection or abscess: Given the location of the swelling, a dental infection is a plausible cause. The inflammation could be referring pain or swelling to the submandibular area.
- Lymphadenitis: Inflammation of the lymph nodes in the submandibular area could be due to a variety of causes, including infection or autoimmune diseases. The elevated CRP and ESR support an inflammatory process.
- Sialadenitis: Inflammation of the salivary gland (in this case, likely the submandibular gland) could cause swelling in the area and elevated inflammatory markers.
Do Not Miss Diagnoses
- Lymphoma: Although less likely, lymphoma could present with lymphadenopathy (enlarged lymph nodes) and elevated inflammatory markers. It's crucial to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Tuberculosis: TB can cause lymphadenitis and might present with systemic symptoms like elevated ESR and CRP. It's essential to consider TB, especially in endemic areas or in patients with risk factors.
- Deep neck infection: These infections can be life-threatening and require prompt diagnosis and treatment. The presence of severe neck swelling and elevated inflammatory markers warrants consideration of this diagnosis.
Rare Diagnoses
- Actinomycosis: A rare bacterial infection that can cause abscesses or masses in the neck, including the submandibular area.
- Branchial cleft cyst: A congenital anomaly that can become infected and present as a swollen mass in the neck.
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that causes lymphadenitis, often in the cervical region, and can present with fever and elevated inflammatory markers.