Differential Diagnosis for Strawberry Tongue, Cervical, and Inguinal Lymphadenopathy
Single Most Likely Diagnosis
- Kawasaki Disease: This condition is characterized by fever, strawberry tongue, cervical lymphadenopathy, and other symptoms such as rash and conjunctivitis. The presence of strawberry tongue and lymphadenopathy in multiple regions (cervical and inguinal) makes Kawasaki disease a strong candidate.
Other Likely Diagnoses
- Infectious Mononucleosis: Caused by Epstein-Barr virus, this condition can present with lymphadenopathy (including cervical and inguinal), fever, and sometimes a strawberry-like appearance of the tongue due to inflammation. However, the combination of strawberry tongue and specific pattern of lymphadenopathy is less typical.
- Streptococcal Infection: Certain streptococcal infections, like scarlet fever, can cause a strawberry tongue and lymphadenopathy, although the latter is more commonly seen in the cervical region.
- Toxoplasmosis: Although less common, toxoplasmosis can cause lymphadenopathy, which may be generalized, including cervical and inguinal regions. However, strawberry tongue is not a typical finding.
Do Not Miss Diagnoses
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with lymphadenopathy, which may be widespread, including cervical and inguinal regions. While strawberry tongue is not a common feature, any suspicion of lymphoma warrants immediate investigation due to its potential severity.
- Tuberculosis: TB can cause lymphadenopathy, often in the cervical region, but can also affect other areas. A strawberry tongue is not typical, but TB is a critical diagnosis not to miss due to its public health implications and the need for specific treatment.
- HIV Infection: Acute HIV infection can present with a variety of symptoms, including lymphadenopathy and sometimes oral manifestations. While strawberry tongue is not specific, the diagnosis of HIV is crucial for patient management and public health reasons.
Rare Diagnoses
- Systemic Lupus Erythematosus (SLE): SLE can cause a wide range of symptoms, including lymphadenopathy and oral ulcers or changes, but strawberry tongue is not a common feature. However, SLE is a diagnosis that should be considered in patients with multi-system involvement.
- Castleman Disease: This rare disorder can cause lymphadenopathy and sometimes systemic symptoms. While not typically associated with strawberry tongue, its rarity and potential severity make it a consideration in complex cases.