Differential Diagnosis for a 13-year-old Female with Enlarged Lymph Nodes in the Axilla
- The differential diagnosis for a 13-year-old female with enlarged lymph nodes in the axilla can be categorized as follows:
Single Most Likely Diagnosis
- Infectious mononucleosis (Mono): This is a common condition in adolescents, caused by the Epstein-Barr virus, which can lead to lymphadenopathy, including enlarged lymph nodes in the axilla.
- Reactive lymphadenitis: This is a benign condition where lymph nodes become enlarged in response to an infection or inflammation elsewhere in the body, such as a skin infection or a viral upper respiratory tract infection.
Other Likely Diagnoses
- Catatrophic lymphadenitis: This condition is caused by a bacterial infection, such as cat-scratch disease, which can lead to swollen and painful lymph nodes in the axilla.
- Allergic or environmental causes: Exposure to allergens or environmental toxins can cause lymphadenitis, such as contact dermatitis or an allergic reaction to a vaccine.
- Autoimmune disorders: Conditions like rheumatoid arthritis, lupus, or Hashimoto's thyroiditis can cause lymphadenopathy, although these are less common in adolescents.
Do Not Miss Diagnoses
- Lymphoma: Although rare, lymphoma is a type of cancer that can cause lymphadenopathy, and it is essential to rule out this diagnosis, especially if the lymph nodes are persistent, growing, or accompanied by systemic symptoms like fever, weight loss, or night sweats.
- Tuberculosis (TB): TB is a bacterial infection that can cause lymphadenitis, and it is crucial to consider this diagnosis, especially if the patient has been exposed to someone with TB or has traveled to an area with high TB prevalence.
- Hodgkin lymphoma: This type of cancer can cause lymphadenopathy, and it is essential to rule out this diagnosis, especially if the lymph nodes are persistent or accompanied by systemic symptoms.
Rare Diagnoses
- Leukemia: Although rare, leukemia is a type of cancer that can cause lymphadenopathy, and it is essential to consider this diagnosis, especially if the patient has other symptoms like fatigue, pallor, or bleeding tendencies.
- Sarcoidosis: This is a rare autoimmune disorder that can cause lymphadenopathy, although it is more common in adults.
- Kikuchi disease: This is a rare condition that causes lymphadenitis, typically in young women, and is often accompanied by fever and night sweats.