Differential Diagnosis for Abrupt Right Inguinal Lymph Node Inflammation and Abscess
- Single most likely diagnosis:
- Cat scratch disease: This is a common cause of lymph node inflammation and abscess, especially in the inguinal region, often following a cat scratch or bite. The abrupt onset and localized nature of the symptoms make this a plausible diagnosis.
- Other Likely diagnoses:
- Bacterial lymphadenitis: Infections such as Staphylococcus aureus or Streptococcus pyogenes can cause lymph node inflammation and abscess formation. The inguinal region is a common site for such infections, often related to skin infections or wounds.
- Tuberculous lymphadenitis: Although less common in some regions, tuberculosis (TB) can cause lymph node inflammation and abscess, particularly in individuals from endemic areas or with compromised immune systems.
- Sexually transmitted infections (STIs): Conditions like lymphogranuloma venereum (LGV) can cause inguinal lymphadenopathy and abscesses, especially in sexually active individuals.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Malignancy: Although rare, lymphoma or metastatic cancer can present with lymph node enlargement and inflammation. It's crucial to consider this possibility, especially in older adults or those with risk factors for cancer.
- HIV infection: Acute HIV infection can cause lymphadenopathy, and the inguinal region can be involved. Missing this diagnosis could lead to delayed treatment and significant morbidity.
- Lymphatic filariasis: In endemic areas, filariasis can cause lymph node inflammation and abscesses. This diagnosis is critical to consider due to the potential for long-term complications and the need for specific treatment.
- Rare diagnoses:
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that can cause lymph node inflammation and abscess, often in young women.
- Kimura disease: A chronic inflammatory disorder that can cause lymph node enlargement and abscesses, typically in Asian males.
- Castleman disease: A rare lymphoproliferative disorder that can present with lymph node inflammation and abscesses, often requiring specific treatment.