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Differential Diagnosis

  • Single most likely diagnosis
    • Community-acquired pneumonia (CAP): The presence of multifocal consolidation in the lower lobes, along with reactive mediastinal nodes, is consistent with a typical presentation of CAP, which is often caused by bacterial pathogens such as Streptococcus pneumoniae.
  • Other Likely diagnoses
    • Influenza pneumonia: Given the involvement of the lower lobes and the presence of reactive lymph nodes, influenza pneumonia is a plausible diagnosis, especially during flu season.
    • Mycoplasma pneumonia: This atypical pneumonia can present with similar radiographic findings and is known to cause reactive lymphadenopathy.
    • Viral pneumonia (other than influenza): Other viral pathogens can cause similar radiographic patterns and should be considered, especially in immunocompromised patients or during outbreaks.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Tuberculosis (TB): Although less likely given the acute presentation, TB can cause consolidation and lymphadenopathy, and missing this diagnosis could have significant consequences, especially in high-risk populations.
    • Sarcoidosis: While typically presenting with a more chronic course, sarcoidosis can cause lymphadenopathy and pulmonary infiltrates, and its diagnosis is crucial due to its potential for significant morbidity if left untreated.
    • Lymphoma: Although rare, lymphoma can present with mediastinal lymphadenopathy and pulmonary infiltrates, making it a critical diagnosis not to miss due to its implications for treatment and prognosis.
  • Rare diagnoses
    • Fungal pneumonia (e.g., histoplasmosis, cryptococcosis): These infections can cause similar radiographic findings, especially in immunocompromised patients, and should be considered in the appropriate clinical context.
    • Parasitic infections (e.g., paragonimiasis): In endemic areas or in patients with a history of travel to such areas, parasitic infections can cause pulmonary infiltrates and lymphadenopathy, making them rare but important considerations.

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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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