Differential Diagnosis
- Single most likely diagnosis
- Infectious Mononucleosis (Mono) due to Epstein-Barr Virus (EBV): The patient's symptoms, such as fever, sore throat, fatigue, and the positive mono spot test, are consistent with infectious mononucleosis. The laboratory results, including the elevated EBV Viral Capsid IgG and EBV Nuclear Antigen IgG, also support this diagnosis.
- Other Likely diagnoses
- Adenovirus infection: The positive Resp pathogen panel for adenovirus and the patient's symptoms, such as conjunctivitis (pink eye), fever, and respiratory symptoms, suggest that adenovirus may be contributing to the patient's illness.
- Coinfection with other viruses: The patient's symptoms and living situation (college dorm) increase the risk of coinfection with other viruses, such as influenza or respiratory syncytial virus.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although the patient's symptoms are consistent with a viral infection, the presence of fever, malaise, and orthostasis increases the risk of sepsis, which can be life-threatening if not promptly recognized and treated.
- Meningitis or encephalitis: The patient's symptoms, such as headache and fever, could be indicative of meningitis or encephalitis, which are medical emergencies that require prompt diagnosis and treatment.
- Rare diagnoses
- Cytomegalovirus (CMV) infection: Although less likely, CMV infection can present with similar symptoms to EBV and adenovirus, including fever, fatigue, and conjunctivitis.
- Toxoplasmosis: This parasitic infection can cause fever, fatigue, and lymphadenopathy, although it is less likely in this patient given the absence of other risk factors, such as immunocompromisation or exposure to cats.