Differential Diagnosis for Bilateral Neck Swelling with Sore Throat
Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most common cause of sore throat and can be accompanied by bilateral neck swelling due to lymphadenopathy. The presence of viral symptoms such as cough, runny nose, and fever supports this diagnosis.
Other Likely Diagnoses
- Streptococcal Pharyngitis: Caused by Group A beta-hemolytic streptococcus, this condition can lead to severe sore throat and bilateral neck swelling due to lymphadenitis. A rapid streptococcal antigen test or throat culture can confirm the diagnosis.
- Mononucleosis (Infectious Mononucleosis): Caused by Epstein-Barr virus, this condition often presents with sore throat, fever, and significant lymphadenopathy, including bilateral neck swelling.
- Tonsillitis: Inflammation of the tonsils can cause sore throat and may be accompanied by lymphadenopathy, leading to neck swelling.
Do Not Miss Diagnoses
- Lymphoma: Although less common, lymphoma can present with painless lymphadenopathy, including bilateral neck swelling. It's crucial to consider this diagnosis, especially in older adults or those with systemic symptoms like weight loss or night sweats.
- Tuberculosis: TB can cause lymphadenitis, leading to neck swelling, and is often accompanied by systemic symptoms such as fever, weight loss, and night sweats. It's particularly important to consider in individuals from endemic areas or with compromised immune systems.
- Abscess (Peritonsillar or Retropharyngeal): These can cause severe sore throat and neck swelling, and while they might not always present bilaterally, they require urgent attention due to the risk of airway compromise.
Rare Diagnoses
- Castleman Disease: A rare lymphoproliferative disorder that can cause lymphadenopathy, including neck swelling.
- Kawasaki Disease: An acute febrile illness that can present with lymphadenopathy, among other symptoms like rash and conjunctivitis, primarily in children.
- Sarcoidosis: A systemic granulomatous disease that can cause lymphadenopathy, including bilateral neck swelling, though it's more commonly associated with pulmonary symptoms.
- Leukemia: Certain types of leukemia can present with lymphadenopathy and systemic symptoms, though this would be an uncommon initial presentation for bilateral neck swelling and sore throat.