What is the diagnosis for a patient presenting with cat scratch disease (CSD) characterized by fever, leukocytosis, and unilateral lymph node adenopathy?

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Differential Diagnosis for Cat Scratch Fever with Fever, Leukocytosis, and Single Lymph Node Adenopathy

  • Single Most Likely Diagnosis
    • Cat Scratch Disease (Bartonellosis): This is the most likely diagnosis given the presentation of fever, leukocytosis, and single lymph node adenopathy after a cat scratch. The disease is caused by Bartonella henselae and typically presents with a papule or pustule at the site of the scratch, followed by regional lymphadenopathy.
  • Other Likely Diagnoses
    • Infectious Mononucleosis: Caused by Epstein-Barr virus, this condition can present with fever, leukocytosis, and lymphadenopathy, although it typically involves multiple lymph node groups.
    • Toxoplasmosis: A parasitic infection that can cause lymphadenopathy, fever, and leukocytosis, especially in immunocompromised individuals.
    • Lymphogranuloma Venereum: A sexually transmitted infection caused by Chlamydia trachomatis that can present with fever, leukocytosis, and lymphadenopathy, although it typically involves the inguinal lymph nodes.
  • Do Not Miss Diagnoses
    • Lymphoma: Although less likely, lymphoma can present with lymphadenopathy, fever, and leukocytosis, and is a critical diagnosis not to miss due to its significant implications for treatment and prognosis.
    • Tuberculosis: Can cause lymphadenopathy, fever, and leukocytosis, and is a critical diagnosis to consider, especially in immunocompromised individuals or those with exposure history.
    • Sarcoidosis: A systemic granulomatous disease that can cause lymphadenopathy, fever, and leukocytosis, and can be life-threatening if not diagnosed and treated properly.
  • Rare Diagnoses
    • Brucellosis: A zoonotic infection that can cause fever, leukocytosis, and lymphadenopathy, although it is relatively rare and typically associated with exposure to infected animals or their products.
    • Tularemia: A bacterial infection caused by Francisella tularensis that can present with fever, leukocytosis, and lymphadenopathy, although it is relatively rare and typically associated with exposure to infected animals or contaminated water.
    • Yersiniosis: A bacterial infection caused by Yersinia enterocolitica that can cause fever, leukocytosis, and lymphadenopathy, although it is relatively rare and typically associated with exposure to contaminated food or water.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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