Differential Diagnosis for Anterior Neck Swelling with Painful Swallowing Post-Flu Infection in a 10-Year-Old
- Single Most Likely Diagnosis
- Acute lymphadenitis or reactive lymphadenopathy: This condition is an inflammatory response to a recent infection, such as the flu, leading to swollen and painful lymph nodes in the neck. The recent history of flu infection and the symptoms of anterior neck swelling with pain upon swallowing align closely with this diagnosis.
- Other Likely Diagnoses
- Peritonsillar abscess or other deep neck infections: Although less common, these conditions can occur after a viral infection like the flu and cause significant pain and swelling, especially if the infection spreads to the tissues around the tonsils or deeper into the neck.
- Thyroiditis: Inflammation of the thyroid gland, which can be triggered by a viral infection, leading to neck pain and swelling. The pain with swallowing is a common symptom due to the thyroid's location.
- Do Not Miss Diagnoses
- Epiglottitis: A potentially life-threatening condition that can cause severe swelling of the epiglottis, leading to difficulty swallowing and breathing. Although less common in the era of widespread vaccination against Haemophilus influenzae type b (Hib), it remains a critical diagnosis not to miss due to its high mortality rate if not promptly treated.
- Retropharyngeal abscess: A serious infection in the tissues at the back of the throat, which can lead to severe swelling, pain with swallowing, and potentially life-threatening airway obstruction if not promptly diagnosed and treated.
- Rare Diagnoses
- Kawasaki disease: An acute febrile illness of childhood characterized by inflammation in the walls of medium-sized arteries throughout the body, which can sometimes present with lymphadenopathy and neck swelling, although it is less commonly associated with pain on swallowing.
- Tuberculosis (TB) lymphadenitis: Although rare in many parts of the world, TB can cause lymph node swelling and pain, especially in the neck. The diagnosis would be considered more likely if there was a known exposure to TB or if the child had recently traveled to or immigrated from an area with high TB prevalence.
- Sarcoidosis: A systemic granulomatous disease that can rarely affect children and cause lymphadenopathy, among other symptoms. It would be an unusual cause of acute neck swelling and pain with swallowing in a child with a recent flu infection.