What is the diagnosis for a swelling lump in the axilla (armpit) with abscess discharge?

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Differential Diagnosis for Swelling Lump on Axillary with Abscess Discharge

  • Single most likely diagnosis
    • Hidradenitis suppurativa: This condition is characterized by recurrent, painful abscesses and nodules in the apocrine-gland-bearing areas, such as the axilla. The presence of a swelling lump with abscess discharge in the axillary region makes hidradenitis suppurativa a strong candidate for the diagnosis.
  • Other Likely diagnoses
    • Furuncle or carbuncle: These are types of skin infections that can cause abscesses, often in areas with hair follicles, such as the axilla. They can present as swollen, painful lumps with discharge.
    • Cystic hygroma or axillary cyst: Although less common, these conditions can cause lumps in the axillary region and may become infected, leading to abscess discharge.
    • Cat scratch disease: This bacterial infection can cause lymphadenopathy (swollen lymph nodes) and abscesses in the axilla, especially if the scratch occurred on the arm.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Tuberculosis (TB) lymphadenitis: Although less common, TB can cause lymph node swelling and abscesses in the axilla. Missing this diagnosis could lead to severe consequences, including the spread of TB.
    • Malignancy (e.g., lymphoma, breast cancer): In rare cases, a swelling lump in the axilla with abscess discharge could be a sign of an underlying malignancy. It is crucial to rule out these conditions to ensure timely treatment.
  • Rare diagnoses
    • Actinomycosis: This rare bacterial infection can cause abscesses and draining sinuses in the skin, including the axilla.
    • Mycetoma: A chronic, granulomatous infection caused by fungi or bacteria, which can lead to swelling, sinus formation, and discharge in the affected area, including the axilla.
    • Axillary lymphadenitis due to other rare infections (e.g., melioidosis, brucellosis): These conditions are uncommon but can cause lymph node swelling and abscesses in the axilla.

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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