Differential Diagnosis for Swollen Mesenteric Lymph Nodes in an Otherwise Healthy 7-Year-Old
Single Most Likely Diagnosis
- Mesenteric lymphadenitis: This condition is often seen in children and is usually caused by a viral infection, leading to swollen lymph nodes in the mesentery. It can mimic appendicitis but is typically self-limiting and resolves without specific treatment.
Other Likely Diagnoses
- Gastroenteritis: Viral or bacterial infections causing gastroenteritis can lead to mesenteric lymphadenitis. The symptoms often include abdominal pain, diarrhea, and vomiting.
- Appendicitis: Although appendicitis is more commonly associated with pain migration to the right lower quadrant, it can sometimes present with mesenteric lymphadenitis, especially if the appendix is retrocecal.
- Infectious mononucleosis (mono): Caused by Epstein-Barr virus (EBV), mono can lead to lymphadenopathy, including mesenteric lymph nodes, along with fever, sore throat, and fatigue.
Do Not Miss Diagnoses
- Lymphoma: Although rare in children, lymphoma (such as Hodgkin lymphoma or non-Hodgkin lymphoma) can present with lymphadenopathy, including in the mesentery. Early diagnosis is crucial for effective treatment.
- Tuberculosis: TB can cause lymphadenitis, including in the mesenteric nodes, especially in areas where TB is common. It's essential to consider TB in the differential to ensure appropriate treatment.
- Intussusception: This condition, where a part of the intestine telescopes into another, can cause abdominal pain and swollen lymph nodes. It's a medical emergency requiring prompt diagnosis and treatment.
Rare Diagnoses
- Sarcoidosis: A rare condition in children, sarcoidosis can cause lymphadenopathy, including in the mesentery, along with other systemic symptoms.
- Histoplasmosis: A fungal infection that can cause lymphadenitis, including in the mesenteric nodes, especially in endemic areas.
- Castleman disease: A rare lymphoproliferative disorder that can present with lymphadenopathy, including in the mesentery, and systemic symptoms.