Differential Diagnosis for Labial/Vaginal Region Pain and Swelling
Single Most Likely Diagnosis
- Bartholin's cyst or abscess: This is the most likely diagnosis given the patient's symptoms of a painful cyst/abscess in the labial area, severe pain, and swelling. The location and recurrent nature of the pain, particularly on the right labial area, are consistent with a Bartholin's cyst or abscess, which is a common condition affecting the Bartholin's glands located on each side of the vaginal opening.
Other Likely Diagnoses
- Furuncle or carbuncle: These are skin infections that can occur in the labial area, causing pain, swelling, and sometimes pus. The absence of fever does not rule out this diagnosis, as some skin infections can be localized without systemic symptoms.
- Vulvar folliculitis: This condition involves inflammation of the hair follicles in the vulvar area, which can cause pain, swelling, and sometimes pus-filled bumps. It's a common condition that could explain the patient's symptoms.
- Vulvar cyst: A vulvar cyst, such as an epidermal inclusion cyst, could cause a painful lump in the labial area, especially if it becomes inflamed or infected.
Do Not Miss Diagnoses
- Necrotizing fasciitis: Although rare, this is a life-threatening condition that requires immediate attention. It involves a severe infection of the tissue under the skin, including fat and fascia, and can be identified by severe pain out of proportion to the physical findings, swelling, and sometimes a foul odor. The absence of fever does not rule out this diagnosis.
- Malignancy: Although less likely, a new, painful mass in the labial area could potentially be a sign of a malignancy, such as vulvar cancer. This diagnosis should be considered, especially in older patients or those with risk factors for cancer.
Rare Diagnoses
- Hydrocele of the labia: This is a rare condition where a fluid-filled cyst forms in the labia, which could cause swelling and discomfort.
- Vulvar endometriosis: In rare cases, endometriosis can occur in the vulvar area, leading to painful cysts or nodules, especially during menstruation.
- Tuberculosis or other granulomatous infections: These are rare causes of chronic infections that could present with painful swellings in the genital area, including the labia.