Differential Diagnosis for Cervical Lymphadenopathy
Single Most Likely Diagnosis
- Reactive Lymphadenitis: This is the most common cause of cervical lymphadenopathy, often resulting from a viral upper respiratory tract infection. The lymph nodes are typically tender, mobile, and less than 1 cm in size.
Other Likely Diagnoses
- Tuberculosis: A significant cause of cervical lymphadenopathy, especially in endemic areas or in individuals with risk factors such as immunocompromised states. Symptoms can include fever, night sweats, and weight loss.
- Streptococcal or Staphylococcal Infections: Bacterial infections can cause lymphadenopathy, often associated with signs of infection like redness, warmth, and swelling in the affected area.
- Toxoplasmosis: Especially in immunocompromised patients, toxoplasmosis can cause cervical lymphadenopathy. It's often associated with other systemic symptoms.
- Mononucleosis (Infectious Mononucleosis): Caused by Epstein-Barr virus, it can lead to lymphadenopathy, fever, and sore throat.
Do Not Miss Diagnoses
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with cervical lymphadenopathy. It's crucial to consider this diagnosis, especially in the absence of infectious symptoms or if the lymphadenopathy is persistent or growing.
- Metastatic Cancer: Cancers of the head and neck, lung, or breast can metastasize to cervical lymph nodes. A thorough examination and history are essential to identify risk factors or primary tumor sites.
- HIV: Human Immunodeficiency Virus infection can cause persistent generalized lymphadenopathy. Identifying HIV is critical due to its significant implications for patient management and prognosis.
Rare Diagnoses
- Sarcoidosis: A systemic granulomatous disease that can cause lymphadenopathy, among other symptoms like skin lesions, eye involvement, and pulmonary symptoms.
- Kikuchi Disease (Histocytic Necrotizing Lymphadenitis): A rare, self-limiting condition that predominantly affects young women, presenting with cervical lymphadenopathy and fever.
- Castleman Disease: A rare disorder that can cause lymphadenopathy, often associated with systemic symptoms like fever and weight loss. It can be unicentric (localized) or multicentric (systemic).
- Kimura Disease: A chronic inflammatory disorder that can cause lymphadenopathy, typically in the head and neck region, and is often associated with eosinophilia and IgE elevation.