Differential Diagnosis for Lymphadenopathy in an Unvaccinated Child
Single Most Likely Diagnosis
- Infectious Mononucleosis (caused by Epstein-Barr Virus): This is a common cause of lymphadenopathy in children, especially if they are unvaccinated and thus more susceptible to viral infections. The disease often presents with fever, sore throat, and fatigue, in addition to lymph node enlargement.
Other Likely Diagnoses
- Streptococcal Pharyngitis: Caused by Group A beta-hemolytic streptococcus, this infection can lead to lymphadenopathy, particularly in the cervical region, along with symptoms like sore throat and fever.
- Tuberculosis (TB): Although less common in some regions, TB is a significant consideration in unvaccinated children, especially if they have been exposed to someone with active TB. It can cause lymphadenopathy, often in the cervical or supraclavicular regions, along with systemic symptoms like fever and weight loss.
- Cat-Scratch Disease (Bartonellosis): This bacterial infection, transmitted through cat scratches, can cause lymphadenopathy, usually near the site of the scratch, along with other symptoms like fever and a papule at the scratch site.
Do Not Miss Diagnoses
- Hodgkin Lymphoma: A type of cancer that can cause lymphadenopathy, often in the cervical, supraclavicular, or mediastinal regions. It's crucial to consider this diagnosis to ensure timely treatment.
- Non-Hodgkin Lymphoma: Another form of lymphoma that can present with lymphadenopathy, systemic symptoms, and sometimes abdominal masses or neurological symptoms.
- Leukemia: Both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) can cause lymphadenopathy, along with other symptoms like pallor, fatigue, and petechiae.
Rare Diagnoses
- Kawasaki Disease: An autoimmune condition that can cause lymphadenopathy, along with fever, rash, conjunctivitis, and changes to the lips and oral cavity. It's rare but important to diagnose due to the risk of cardiac complications.
- Castleman Disease: A rare disorder that can cause lymphadenopathy, often with systemic symptoms like fever and weight loss. It can be unicentric (localized) or multicentric (widespread).
- Lymphoma associated with immunodeficiency: In children with underlying immunodeficiencies, there's an increased risk of developing lymphomas, which can present with lymphadenopathy among other symptoms.