Differential Diagnosis for Posterior Cervical Lymphadenopathy with Tonsillitis
- Single most likely diagnosis
- Infectious mononucleosis (caused by Epstein-Barr virus): This is a common condition that often presents with tonsillitis, fever, and lymphadenopathy, including posterior cervical lymphadenopathy. The presence of these symptoms together makes it a likely diagnosis.
- Other Likely diagnoses
- Streptococcal pharyngitis: This bacterial infection can cause tonsillitis and is often accompanied by lymphadenopathy, including in the posterior cervical region. It's a common condition that should be considered.
- Viral pharyngitis: Other viral infections can also cause tonsillitis and lymphadenopathy. These are common and should be considered in the differential diagnosis.
- Reactive lymphadenopathy: This is a non-specific response to infection or inflammation in the body, which can cause lymphadenopathy, including in the posterior cervical region, in response to tonsillitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: Although less common, lymphoma can present with lymphadenopathy and should not be missed due to its serious implications. It's crucial to consider this in the differential diagnosis, especially if symptoms persist or worsen over time.
- Tuberculosis: TB can cause lymphadenopathy, including in the posterior cervical region, and is important not to miss due to its potential for serious morbidity if left untreated.
- HIV infection: Acute HIV infection can present with symptoms similar to infectious mononucleosis, including lymphadenopathy and tonsillitis. Missing this diagnosis could have significant consequences for the patient's health and treatment.
- Rare diagnoses
- Toxoplasmosis: This parasitic infection can cause lymphadenopathy but is less common and typically associated with other symptoms such as fever and fatigue.
- Cytomegalovirus (CMV) infection: Similar to EBV, CMV can cause a mononucleosis-like syndrome with lymphadenopathy, but it's less common and often seen in specific populations (e.g., immunocompromised individuals).
- Cat-scratch disease: Caused by Bartonella henselae, this infection can lead to lymphadenopathy, usually after a cat scratch or bite, and is more commonly seen in children.