Differential Diagnosis for a 23-year-old Male with Sore Throat, Tonsillar Swelling, and Episode of Hemoptysis
- Single Most Likely Diagnosis
- Infectious mononucleosis (mono): This condition, caused by the Epstein-Barr virus, is common in young adults and can present with sore throat, tonsillar swelling, and sometimes hemoptysis due to severe throat infection or rupture of a vessel.
- Other Likely Diagnoses
- Streptococcal pharyngitis: A bacterial infection that can cause severe sore throat and tonsillar swelling. Hemoptysis could occur if there's significant inflammation or a complication like a peritonsillar abscess that erodes into a blood vessel.
- Influenza or other viral upper respiratory infections: These can cause sore throat and, in severe cases, lead to secondary bacterial infections or complications that might result in hemoptysis.
- Tonsillitis: Inflammation of the tonsils, which can be caused by viral or bacterial infections, leading to sore throat and swelling. Hemoptysis is less common but could occur with severe infection or abscess formation.
- Do Not Miss Diagnoses
- Lemierre's syndrome: A rare but potentially life-threatening condition that starts with pharyngitis and can progress to septic thrombophlebitis of the internal jugular vein, leading to severe complications including hemoptysis.
- Pulmonary embolism: Although less directly related to the primary symptoms, any condition that leads to immobilization or increases the risk of thrombosis (like severe infection) could potentially lead to a pulmonary embolism, which can cause hemoptysis.
- Lung cancer: Extremely rare in a young adult but could present with hemoptysis. Other symptoms like weight loss, cough, or systemic symptoms might also be present.
- Rare Diagnoses
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect the respiratory tract and kidneys, presenting with symptoms like sore throat, hemoptysis, and potentially renal issues.
- Goodpasture's syndrome: An autoimmune disease that affects the lungs and kidneys, characterized by hemoptysis and renal failure, though it's very rare and typically presents with more systemic symptoms.
- Kaposi's sarcoma: In immunocompromised patients, this could present with oral lesions and potentially hemoptysis if there's pulmonary involvement, though it's rare and usually associated with other symptoms and a known immunocompromised state.