Differential Diagnosis for Lymphadenopathies in the Neck in Pediatrics

Single Most Likely Diagnosis

• Viral upper respiratory tract infection: This is the most common cause of lymphadenopathy in the neck in pediatric patients, often presenting with tender lymph nodes and accompanying symptoms such as sore throat, cough, and runny nose.

Other Likely Diagnoses

• Streptococcal pharyngitis: Caused by Group A beta-hemolytic streptococcus, this condition often presents with lymphadenopathy, sore throat, and fever.
• Reactive lymphadenitis: This condition occurs in response to a nearby infection, such as a skin or soft tissue infection, and can cause lymphadenopathy.
• Tuberculosis: Although less common in some regions, tuberculosis can cause lymphadenopathy, particularly in the neck, and is often accompanied by systemic symptoms such as fever, weight loss, and night sweats.
• Cat-scratch disease: Caused by Bartonella henselae, this condition typically presents with lymphadenopathy, often in the neck, following a cat scratch or bite.

Do Not Miss Diagnoses

• Hodgkin lymphoma: A type of cancer that can cause lymphadenopathy, often in the neck, and is accompanied by systemic symptoms such as fever, weight loss, and night sweats.
• Non-Hodgkin lymphoma: Another type of cancer that can cause lymphadenopathy, often in the neck, and can be accompanied by systemic symptoms.
• Leukemia: Certain types of leukemia, such as acute lymphoblastic leukemia, can cause lymphadenopathy, often in the neck, and are accompanied by systemic symptoms such as fatigue, weight loss, and easy bruising.
• Retropharyngeal abscess: A serious infection that can cause lymphadenopathy and neck swelling, often accompanied by difficulty swallowing, breathing, and neck stiffness.

Rare Diagnoses

• Kawasaki disease: A rare condition that can cause lymphadenopathy, often in the neck, and is accompanied by fever, rash, and swelling of the hands and feet.
• Sarcoidosis: A rare condition that can cause lymphadenopathy, often in the neck, and is accompanied by systemic symptoms such as fever, weight loss, and night sweats.
• Lymphoma associated with immunodeficiency: Certain immunodeficiency conditions, such as HIV/AIDS, can increase the risk of developing lymphoma, which can cause lymphadenopathy.
• Castleman disease: A rare condition that can cause lymphadenopathy, often in the neck, and is accompanied by systemic symptoms such as fever, weight loss, and night sweats.