Differential Diagnosis for 31-year-old Patient with Palpable Elbow Lymph Nodes
- Single most likely diagnosis:
- Reactive lymphadenopathy: This is the most likely diagnosis given the patient's recent history of picking at an ingrown hair, which could cause a localized immune response leading to lymph node enlargement. The fact that the lymph nodes are moveable and achy also supports this diagnosis.
- Other Likely diagnoses:
- Viral upper respiratory infection: The patient's symptoms of neck muscle tension from stress could be related to a viral upper respiratory infection, which often causes lymphadenopathy.
- Cat scratch disease: Although less common, cat scratch disease could be a consideration if the patient has been exposed to cats, as it can cause lymphadenopathy, especially in the axillary or elbow region.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Lymphoma: Although lymphoma is less common, it is crucial to consider it in the differential diagnosis, as it can present with lymphadenopathy and would require prompt treatment.
- Metastatic cancer: Similarly, metastatic cancer to the lymph nodes is a critical diagnosis not to miss, as it would significantly impact treatment and prognosis.
- Tuberculosis or other granulomatous infections: These infections can cause lymphadenopathy and are essential to consider, especially if the patient has been exposed to someone with TB or has traveled to an area where TB is common.
- Rare diagnoses:
- Kikuchi disease: A rare form of lymphadenitis that can cause lymph node enlargement, often accompanied by fever and night sweats.
- Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy, often accompanied by eosinophilia and IgE elevation.
- Castleman disease: A rare disorder that can cause lymphadenopathy, often accompanied by systemic symptoms such as fever and weight loss.