What is the cause of recurrent daily fevers, pulmonary infiltrates, and lymphadenopathy in a 20-year-old female with a positive Antinuclear Antibody (ANA) test, despite treatment for infection?

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Differential Diagnosis for 20 yo Female with Pulmonary Infiltrates, Lymphadenopathy, and Recurrent Fevers

  • Single Most Likely Diagnosis
    • Systemic Lupus Erythematosus (SLE): The presence of pulmonary infiltrates, lymphadenopathy, recurrent fevers, and a positive antinuclear antibody (ANA) test are all consistent with SLE, a chronic autoimmune disease that can affect multiple organ systems.
  • Other Likely Diagnoses
    • Sarcoidosis: This condition can cause pulmonary infiltrates, lymphadenopathy, and fever, and can also be associated with a positive ANA test in some cases.
    • Rheumatoid Arthritis (RA): While RA is more commonly associated with joint symptoms, it can also cause pulmonary infiltrates, lymphadenopathy, and fever, and some patients with RA may have a positive ANA test.
    • Mixed Connective Tissue Disease (MCTD): This condition overlaps with SLE, RA, and other autoimmune diseases, and can cause a variety of symptoms including pulmonary infiltrates, lymphadenopathy, and fever.
  • Do Not Miss Diagnoses
    • Lymphoma: This is a type of cancer that can cause lymphadenopathy, fever, and pulmonary infiltrates, and would be a critical diagnosis to miss.
    • Tuberculosis (TB): While the patient has been treated for infection, TB can be difficult to diagnose and would be a critical diagnosis to miss, especially if the patient has been exposed to someone with TB or has traveled to an area where TB is common.
    • Histoplasmosis: This is a fungal infection that can cause pulmonary infiltrates, lymphadenopathy, and fever, and would be a critical diagnosis to miss, especially if the patient has been exposed to bird or bat droppings.
  • Rare Diagnoses
    • Wegener's Granulomatosis: This is a rare autoimmune disease that can cause pulmonary infiltrates, lymphadenopathy, and fever, but is less likely than some of the other diagnoses on this list.
    • Churg-Strauss Syndrome: This is another rare autoimmune disease that can cause pulmonary infiltrates, lymphadenopathy, and fever, but is less likely than some of the other diagnoses on this list.
    • Eosinophilic Granuloma with Polyangiitis (EGPA): This is a rare condition that can cause pulmonary infiltrates, lymphadenopathy, and fever, but is less likely than some of the other diagnoses on this list.

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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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