Differential Diagnosis for a 20-year-old with Night Sweats, Sore Throat, and Weight Loss
Single Most Likely Diagnosis
- Tuberculosis (TB): This diagnosis is highly considered due to the classic combination of symptoms such as night sweats, sore throat, and weight loss, which are commonly associated with TB, especially in regions with high prevalence.
Other Likely Diagnoses
- Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus, mono can present with sore throat, fever, and weight loss. Night sweats can also occur, although they are less common.
- HIV Infection: Early stages of HIV can manifest with non-specific symptoms including weight loss, sore throat, and night sweats due to the body's immune response to the virus.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with systemic symptoms like weight loss, night sweats, and sore throat, particularly if the lymphoma involves the throat or mediastinum.
Do Not Miss Diagnoses
- Meningitis: Although less likely to present with this exact combination of symptoms, meningitis can cause severe illness and death if not promptly treated. Certain types, like tuberculous meningitis, might have a more insidious onset with weight loss and night sweats.
- Endocarditis: Infective endocarditis can present with non-specific symptoms including weight loss, night sweats, and possibly a sore throat if there is an embolic phenomenon affecting the throat or if the patient has a heart condition that predisposes to endocarditis.
- Sarcoidosis: This autoimmune disease can affect multiple systems and present with a variety of symptoms, including weight loss, night sweats, and sore throat, especially if there is lymph node involvement in the neck.
Rare Diagnoses
- Brucellosis: A zoonotic infection that can cause fever, night sweats, weight loss, and possibly sore throat, although it's less common and typically associated with exposure to infected animals or their products.
- Histoplasmosis: A fungal infection that can cause systemic symptoms similar to TB, including night sweats, weight loss, and sore throat, particularly in immunocompromised individuals or those exposed to the fungus in endemic areas.
- Castleman Disease: A rare lymphoproliferative disorder that can present with systemic symptoms such as weight loss, night sweats, and possibly sore throat, depending on the location and extent of lymph node involvement.