Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 9, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis

  • Single most likely diagnosis
    • Cytomegalovirus (CMV) infection: The patient's symptoms, including fatigue, decreased appetite, sore throat, odynophagia, fever, and a scattered erythematous rash, are consistent with CMV infection. The lack of response to amoxicillin and negative rapid strep and heterophile tests also support this diagnosis. CMV can cause a mononucleosis-like syndrome, which is often indistinguishable from Epstein-Barr virus (EBV) infection.
  • Other Likely diagnoses
    • Epstein-Barr virus (EBV) infection: Although the heterophile test was negative, it is not 100% sensitive, especially early in the course of the disease. EBV infection can cause similar symptoms, including fever, sore throat, and lymphadenopathy.
    • Toxoplasmosis: This parasitic infection can cause a mononucleosis-like syndrome, including fever, lymphadenopathy, and rash.
    • Acute HIV infection: The patient's symptoms, including fever, rash, and lymphadenopathy, can be seen in acute HIV infection.
  • Do Not Miss
    • Streptococcal pharyngitis with scarlet fever: Although the rapid strep test was negative, it is possible that the patient has a false-negative result. Scarlet fever can cause a rash and fever, and it is essential to consider this diagnosis to avoid missing a treatable bacterial infection.
    • Lymphoma: Although rare, lymphoma can cause lymphadenopathy, fever, and rash. It is essential to consider this diagnosis to avoid missing a potentially life-threatening condition.
  • Rare diagnoses
    • Infectious mononucleosis caused by human herpesvirus 6 (HHV-6) or human herpesvirus 8 (HHV-8): These viruses can cause a mononucleosis-like syndrome, but they are less common than CMV or EBV.
    • Brucellosis: This bacterial infection can cause fever, lymphadenopathy, and rash, but it is relatively rare in the general population.
    • Cat-scratch disease: This bacterial infection can cause lymphadenopathy, fever, and rash, but it is typically associated with a history of cat exposure.

Related Questions

Are elevated liver enzymes related to enzyme dysfunction?
What is the acceptable drainage output to remove drains after mastectomy?
What additional treatments can be considered for a stable patient with subgaleal hematoma and subarachnoid hemorrhage during transfer to ICU?
What is the treatment for hyperthyroidism indicated by a low Thyroid-Stimulating Hormone (TSH) level?
Why does the CT scan show no evidence of hemorrhage in a patient with seizure, headache, stiff neck, and non-responsiveness, with cerebrospinal fluid (CSF) analysis showing elevated red blood cells (RBC), protein, and white blood cells (WBC), and yellow discoloration?

Professional Medical Disclaimer

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question