Differential Diagnosis
The patient's symptoms of generalized lymphadenopathy, intermittent low-grade fever, and a cystic lesion in the spleen can be attributed to various conditions. Here's a categorized differential diagnosis:
Single most likely diagnosis
- C. TB (Tuberculosis): TB can cause generalized lymphadenopathy, intermittent low-grade fever, and can affect the spleen, although splenic involvement is less common. The cystic lesion in the spleen could be a tuberculous abscess.
Other Likely diagnoses
- A. Kala azar (Visceral Leishmaniasis): This condition can cause generalized lymphadenopathy, fever, and splenomegaly, which might include cystic lesions due to the disease process or secondary infections.
- B. Malaria: Certain types of malaria, especially those caused by Plasmodium vivax, can lead to splenomegaly and might cause lymphadenopathy. However, cystic lesions in the spleen are less commonly associated directly with malaria.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with generalized lymphadenopathy and systemic symptoms like fever. Splenic involvement is common, and while less typical, cystic lesions could occur, especially in the context of lymphomatous infiltration.
- Sarcoidosis: This condition can cause lymphadenopathy and systemic symptoms. Although less common, it can involve the spleen and potentially cause cystic lesions, especially in advanced disease.
Rare diagnoses
- Histoplasmosis: A fungal infection that can cause lymphadenopathy, fever, and splenic lesions, including cystic ones, especially in immunocompromised patients.
- Cystic echinococcosis (Hydatid disease): Caused by the Echinococcus parasite, this condition can lead to cystic lesions in various organs, including the spleen, and might be accompanied by lymphadenopathy and fever if there's a significant inflammatory response or secondary infection.