Differential Diagnosis for EBV Infection
To assess whether you have had EBV (Epstein-Barr Virus) infection, I will need to ask a series of questions. However, based on the initial presentation, here is a differential diagnosis:
- Single Most Likely Diagnosis
- Infectious Mononucleosis (Mono): This is the most common manifestation of EBV infection, characterized by fever, sore throat, swollen lymph nodes, and fatigue. The justification for this being the single most likely diagnosis is that it is the primary disease associated with EBV infection.
- Other Likely Diagnoses
- Chronic Fatigue Syndrome: Some individuals may experience prolonged fatigue after an EBV infection, which could be a manifestation of chronic fatigue syndrome. This is considered because EBV is known to cause prolonged illness in some cases.
- Autoimmune Disorders: EBV has been linked to the development of certain autoimmune disorders, such as multiple sclerosis and lupus, although the exact mechanism is not fully understood. These are considered due to the potential long-term consequences of EBV infection.
- Do Not Miss Diagnoses
- Hodgkin Lymphoma: EBV is associated with an increased risk of developing Hodgkin lymphoma, a type of cancer that affects the immune system. This is a critical diagnosis not to miss due to its severe implications and the need for early treatment.
- Burkitt Lymphoma: Another cancer associated with EBV, particularly in Africa. Early diagnosis is crucial for effective treatment.
- Rare Diagnoses
- X-Linked Lymphoproliferative Disease (XLP): A rare genetic disorder that affects the immune system's ability to respond to EBV, leading to severe complications. This is considered rare but important due to its severe prognosis if not recognized and managed appropriately.
- EBV-Associated Hemophagocytic Lymphohistiocytosis (HLH): A rare and potentially life-threatening condition of the immune system. It's essential to consider this due to its high mortality rate if not promptly treated.
To further assess whether you have had EBV, my first question is: Have you ever experienced a period of prolonged fever, sore throat, and swollen lymph nodes, particularly during adolescence or young adulthood?