What is the cause of palpable elbow lymph nodes and fullness under the left ribs in a 31-year-old female with left shoulder tension and a history of a scratched and healed ingrown hair (folliculitis)?

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Differential Diagnosis for Palpable Elbow Lymph Nodes and Fullness Under Left Ribs

Single Most Likely Diagnosis

  • Cat Scratch Disease: This diagnosis is likely due to the patient's history of an ingrown hair that was scratched, which could have introduced the Bartonella henselae bacteria into the body. The presence of palpable elbow lymph nodes and fullness under the left ribs could be indicative of lymphadenopathy, a common symptom of cat scratch disease.

Other Likely Diagnoses

  • Viral Infections (e.g., Mononucleosis, CMV): These infections can cause lymphadenopathy and are common in young adults. The fullness under the left ribs could be related to splenomegaly, which is often seen in viral infections.
  • Lymphoma: Although less common, lymphoma could be a possible diagnosis, especially if the lymphadenopathy is persistent and accompanied by other symptoms such as weight loss or fatigue.
  • Tuberculosis: This infection can cause lymphadenopathy and is more likely in individuals with a history of exposure or immunocompromised states.

Do Not Miss Diagnoses

  • Lymphoma (Hodgkin's or Non-Hodgkin's): As mentioned earlier, lymphoma is a serious diagnosis that requires prompt attention. It is essential to consider this diagnosis, even if it is less likely, due to its potential severity.
  • Tuberculosis: TB is a serious infection that can have significant consequences if left untreated. It is crucial to consider this diagnosis, especially if the patient has a history of exposure or immunocompromised state.
  • Sarcoidosis: This autoimmune disease can cause lymphadenopathy and is often diagnosed in young adults. It is essential to consider this diagnosis, as it can have significant implications for the patient's health.

Rare Diagnoses

  • Castleman Disease: This rare disorder can cause lymphadenopathy and is often diagnosed in young adults. It is essential to consider this diagnosis, although it is less likely, due to its potential severity.
  • Kikuchi-Fujimoto Disease: This rare condition can cause lymphadenopathy and is often diagnosed in young adults. It is essential to consider this diagnosis, although it is less likely, due to its potential severity.
  • Brucellosis: This rare infection can cause lymphadenopathy and is often associated with exposure to animals or contaminated animal products. It is essential to consider this diagnosis, although it is less likely, due to its potential severity.

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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