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Differential Diagnosis for a 15-year-old with Sore Throat, Adenopathy, and Malaise

  • Single most likely diagnosis:
    • Infectious Mononucleosis (Mono): This is a common illness in adolescents, caused by the Epstein-Barr virus (EBV), characterized by sore throat, fever, adenopathy (especially cervical), and malaise. The patient's age and symptoms align closely with this diagnosis.
  • Other Likely diagnoses:
    • Streptococcal Pharyngitis: Caused by Group A beta-hemolytic streptococcus, this condition presents with sore throat, fever, and adenopathy. It's a common cause of sore throat in children and adolescents.
    • Viral Pharyngitis: Various viruses can cause pharyngitis, leading to symptoms similar to those presented by the patient, including sore throat, malaise, and adenopathy.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Lymphoma: Although rare, lymphomas can present with adenopathy, fever, and malaise. Missing this diagnosis could have severe consequences, making it crucial to consider, especially if symptoms persist or worsen over time.
    • HIV Infection: Acute HIV infection can mimic infectious mononucleosis with symptoms like sore throat, adenopathy, and malaise. Given the potential long-term consequences, it's essential to rule out HIV in patients with these symptoms, especially if risk factors are present.
  • Rare diagnoses:
    • Toxoplasmosis: This parasitic infection can cause adenopathy and mild symptoms similar to mononucleosis, especially in immunocompromised individuals, but it's less common in immunocompetent adolescents.
    • Cytomegalovirus (CMV) Infection: CMV can cause a mononucleosis-like syndrome, but it's less frequently encountered than EBV in this age group and often requires specific risk factors or immunocompromised status.

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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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