Differential Diagnosis for Young Female with 10 Days Fever, Pre-auricular Lymphadenopathy, and High-grade Fever
- Single Most Likely Diagnosis
- Infectious Mononucleosis (caused by Epstein-Barr virus): This condition is characterized by fever, lymphadenopathy (including pre-auricular), and can present with atypical lymphocytes on a differential count, which might explain the low platelet count due to immune-mediated mechanisms.
- Other Likely Diagnoses
- Tuberculosis: Although less common in this presentation, TB can cause prolonged fever, lymphadenopathy, and can affect the blood counts in various ways, including thrombocytopenia.
- Brucellosis: This zoonotic infection can cause fever, lymphadenopathy, and hematological abnormalities, including thrombocytopenia.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with lymphadenopathy, fever, and abnormalities in blood cell counts.
- Do Not Miss Diagnoses
- Meningitis or Encephalitis: Although the primary symptoms do not directly suggest CNS infection, the presence of high-grade fever and lymphadenopathy necessitates consideration of these potentially life-threatening conditions, especially if there are any neurological symptoms.
- Sepsis: Any patient with high-grade fever and significant lymphadenopathy should be evaluated for sepsis, particularly if there are signs of organ dysfunction.
- HIV Infection: Acute HIV infection can present with fever, lymphadenopathy, and a variety of hematological abnormalities.
- Rare Diagnoses
- Cytomegalovirus (CMV) Infection: Similar to EBV, CMV can cause a mononucleosis-like syndrome with fever, lymphadenopathy, and atypical lymphocytes.
- Toxoplasmosis: This parasitic infection can cause lymphadenopathy and fever, particularly in immunocompromised individuals.
- Castleman Disease: A rare disorder that can cause lymphadenopathy, fever, and hematological abnormalities, including thrombocytopenia.
Each of these diagnoses should be considered in the context of the patient's full clinical presentation, epidemiological history, and further diagnostic testing as necessary.