Differential Diagnosis for Night Sweats and Fatigue in a 15-year-old Female
Single Most Likely Diagnosis
- Anxiety or Stress: Night sweats can be associated with anxiety or stress, which are common in adolescents due to school pressures, social issues, or family problems. Fatigue is also a frequent complaint in this context.
Other Likely Diagnoses
- Mononucleosis (Infectious Mononucleosis): Caused by Epstein-Barr virus, it can present with fatigue, night sweats, and other symptoms like sore throat and lymphadenopathy.
- Hypothyroidism: Although less common, hypothyroidism can cause fatigue and night sweats among other symptoms like weight gain and cold intolerance.
- Anemia: Iron deficiency anemia or other forms of anemia can lead to fatigue, and in some cases, night sweats due to the body's decreased ability to regulate temperature effectively.
- Pubertal Changes: The onset of puberty can bring about various physical and emotional changes, including fatigue and possibly night sweats due to hormonal fluctuations.
Do Not Miss Diagnoses
- Tuberculosis (TB): Although less common in some regions, TB is a critical diagnosis not to miss, as it can present with night sweats, fatigue, and weight loss.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with systemic symptoms like night sweats, fatigue, and weight loss.
- Diabetes Mellitus: Type 1 diabetes can sometimes present with fatigue and night sweats due to high blood sugar levels affecting the body's ability to regulate fluids and temperature.
- Endocrine Disorders (e.g., Addison's Disease, Hyperthyroidism): These conditions can cause a variety of symptoms including fatigue and night sweats due to hormonal imbalances.
Rare Diagnoses
- Brucellosis: A zoonotic infection that can cause fever, night sweats, and fatigue, though it's relatively rare and usually associated with specific occupational exposures.
- Histoplasmosis: A fungal infection that can cause systemic symptoms including night sweats and fatigue, more common in certain geographic areas or in immunocompromised individuals.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic symptoms including sweating, though night sweats and fatigue might be part of the presentation due to catecholamine excess.