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Last updated: October 23, 2025View editorial policy

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Differential Diagnosis for Swollen and Painful Glands in the Neck

Single Most Likely Diagnosis

  • Viral Pharyngitis: This is often the most common cause of swollen and painful neck glands, typically resulting from a viral infection such as mononucleosis or the common cold. The symptoms usually include sore throat, fever, and swollen lymph nodes in the neck.

Other Likely Diagnoses

  • Bacterial Pharyngitis: Caused by bacteria like Streptococcus, this condition also leads to swollen and painful lymph nodes in the neck, accompanied by a sore throat and fever.
  • Tonsillitis: Inflammation of the tonsils can cause pain and swelling in the neck glands, often due to bacterial or viral infections.
  • Lymphadenitis: An infection of the lymph nodes themselves, which can be caused by bacteria or other pathogens, leading to swollen and painful glands in the neck.

Do Not Miss Diagnoses

  • Hodgkin Lymphoma: A type of cancer that can cause swollen lymph nodes in the neck, among other symptoms. Although less common, it's critical to consider due to its serious implications.
  • Tuberculosis (TB): A bacterial infection that can affect the lungs but also cause swollen and painful lymph nodes in the neck. Given its potential severity and the importance of early treatment, TB should not be overlooked.
  • Human Immunodeficiency Virus (HIV): Acute HIV infection can present with swollen lymph nodes, among other flu-like symptoms. Early diagnosis is crucial for effective management.

Rare Diagnoses

  • Cat-Scratch Disease: Caused by the bacterium Bartonella henselae, transmitted through cat scratches or bites, leading to swollen and painful lymph nodes, typically near the site of the scratch.
  • Toxoplasmosis: A parasitic infection that can cause swollen lymph nodes, especially in individuals with weakened immune systems.
  • Sarcoidosis: A condition characterized by the growth of granulomas (inflammatory cells) in various parts of the body, including the lymph nodes in the neck, leading to swelling and pain.

Professional Medical Disclaimer

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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