Differential Diagnosis for Pharyngitis and Pulmonary Nodules
- Single Most Likely Diagnosis
- Infectious Mononucleosis (caused by Epstein-Barr virus): This condition often presents with pharyngitis and can be associated with pulmonary nodules or infiltrates, especially in immunocompromised patients. The presence of fever, lymphadenopathy, and fatigue further supports this diagnosis.
- Other Likely Diagnoses
- Tuberculosis: Although less common in some regions, TB can cause both pharyngitis (less commonly) and pulmonary nodules. The diagnosis should be considered, especially in patients with risk factors such as immunocompromise or exposure history.
- Histoplasmosis: This fungal infection can cause pulmonary nodules and, in some cases, pharyngitis, particularly if there is dissemination. It's more likely in endemic areas or in individuals with exposure to bird or bat droppings.
- Sarcoidosis: While more commonly associated with pulmonary findings, sarcoidosis can occasionally present with pharyngeal involvement. The presence of other systemic symptoms such as skin lesions, joint pain, or eye symptoms would support this diagnosis.
- Do Not Miss Diagnoses
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with pharyngitis and pulmonary nodules. Given the potential for aggressive disease and the importance of early treatment, lymphoma must be considered, especially in the presence of systemic symptoms like weight loss or night sweats.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This vasculitis can cause a wide range of symptoms, including pharyngitis and pulmonary nodules. It's crucial to consider this diagnosis due to its potential for severe morbidity and the availability of effective treatment.
- Rare Diagnoses
- Coccidioidomycosis: This fungal infection, endemic to certain parts of the Americas, can cause pulmonary nodules and, less commonly, pharyngitis, especially in disseminated disease.
- Cryptococcosis: Primarily affecting immunocompromised individuals, this fungal infection can cause pulmonary nodules and, in rare cases, pharyngeal lesions.
- Kaposi's Sarcoma: In immunocompromised patients, especially those with HIV/AIDS, Kaposi's sarcoma can present with pulmonary nodules and, less commonly, oral or pharyngeal lesions.