Differential Diagnosis for Swollen and Painful Axillary Lymph Node
- Single Most Likely Diagnosis
- Cat scratch disease: This is a common cause of swollen and painful axillary lymph nodes, especially in individuals who have been scratched by a cat. The bacteria Bartonella henselae is typically the causative agent.
- Other Likely Diagnoses
- Breast cancer: Axillary lymph node swelling can be a sign of breast cancer, particularly if the swelling is unilateral and accompanied by other symptoms such as a breast lump or nipple discharge.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can cause axillary lymph node swelling, often accompanied by systemic symptoms such as fever, weight loss, and fatigue.
- Infections (e.g., bacterial, viral): Various infections can cause axillary lymphadenopathy, including bacterial infections like streptococcal or staphylococcal infections, and viral infections like mononucleosis.
- Do Not Miss Diagnoses
- Tuberculosis: Although less common in some regions, tuberculosis (TB) can cause axillary lymphadenopathy and is crucial to diagnose due to its public health implications and the need for specific treatment.
- Sarcoidosis: This autoimmune disease can cause lymphadenopathy, including in the axillary region, and is important to diagnose due to its potential to affect multiple organ systems.
- Metastatic cancer: Besides breast cancer, other cancers can metastasize to axillary lymph nodes, making a thorough investigation essential.
- Rare Diagnoses
- Kikuchi disease: A rare form of lymphadenitis that primarily affects the cervical lymph nodes but can also involve axillary nodes, often presenting with fever and night sweats.
- Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, more commonly seen in Asian males.
- Castleman disease: A rare disorder that involves an overgrowth of cells in the lymphatic system, which can lead to lymphadenopathy, including in the axillary region.