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Differential Diagnosis for Rapidly Expanding Lymphadenopathy of the Right Neck

Single Most Likely Diagnosis

  • Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus (EBV), it often presents with rapid onset of lymphadenopathy, particularly in the cervical region, along with fever, sore throat, and fatigue. The rapid expansion over 3 weeks fits the timeline for the development of symptoms in infectious mononucleosis.

Other Likely Diagnoses

  • Lymphoma: Both Hodgkin lymphoma and non-Hodgkin lymphoma can present with rapidly enlarging lymph nodes. The right neck is a common location, and the symptoms can develop over a few weeks.
  • Tuberculosis (TB): Although TB typically has a more chronic course, it can cause rapidly expanding lymphadenopathy, especially in immunocompromised individuals or in cases of TB lymphadenitis.
  • Reactive Lymphadenopathy: This can occur in response to various infections or inflammatory conditions and may present with rapid lymph node enlargement.

Do Not Miss Diagnoses

  • Metastatic Cancer: Cancer that has spread to the lymph nodes, such as from head and neck cancers, can cause rapid lymphadenopathy. Missing this diagnosis could lead to delayed treatment of the underlying cancer.
  • HIV Infection: Acute HIV infection can present with rapid onset of lymphadenopathy among other symptoms. Early diagnosis is crucial for the management and treatment of HIV.
  • Cat-Scratch Disease: Caused by Bartonella henselae, this infection can lead to significant lymphadenopathy, typically developing within 1-3 weeks after a cat scratch or bite.

Rare Diagnoses

  • Kikuchi-Fujimoto Disease: A rare, self-limiting condition that predominantly affects young women, characterized by lymphadenopathy, often in the cervical region, and can mimic lymphoma or tuberculosis.
  • Kimura Disease: A 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, among other symptoms.

Each of these diagnoses has distinct features and requires careful consideration based on the patient's history, physical examination, and diagnostic tests to determine the underlying cause of the rapidly expanding lymphadenopathy.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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