Differential Diagnosis for Mild to Moderate Tonsillar Enlargement
Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most common cause of tonsillar enlargement, often presenting with symptoms such as sore throat, fever, and swollen lymph nodes. The viral etiology is usually self-limiting and resolves without specific treatment.
Other Likely Diagnoses
- Streptococcal Pharyngitis: Caused by Group A beta-hemolytic streptococcus, this condition presents similarly to viral pharyngitis but requires antibiotic treatment to prevent complications like rheumatic fever.
- Allergic Rhinitis: Can cause chronic tonsillar enlargement due to persistent allergic stimulation and subsequent lymphoid hyperplasia.
- Tonsillitis: Recurrent or chronic inflammation of the tonsils, which can be due to bacterial or viral infections, and may lead to significant tonsillar enlargement.
Do Not Miss Diagnoses
- Lymphoma: Although rare, lymphoma can present with tonsillar enlargement and is critical to diagnose early due to its significant implications on treatment and prognosis.
- Peritonsillar Abscess: A serious complication of tonsillitis that requires prompt drainage to prevent airway compromise and other severe complications.
- Mononucleosis (Infectious Mononucleosis): Caused by Epstein-Barr virus, it can lead to significant tonsillar enlargement and has implications for diagnosis and management, especially in adolescents and young adults.
Rare Diagnoses
- Tonsillar Carcinoma: A rare malignancy that can present with unilateral tonsillar enlargement, often in older adults with a history of smoking or alcohol use.
- Granulomatosis with Polyangiitis (Wegener's Granulomatosis): A systemic vasculitis that can rarely cause tonsillar enlargement as part of its multi-system involvement.
- Cystic Fibrosis: Although primarily a pulmonary disease, cystic fibrosis can lead to chronic infections and inflammation, potentially causing tonsillar enlargement in some cases.