Differential Diagnosis
- Single most likely diagnosis
- Inguinal lymphadenitis: The patient's symptoms of a swollen inguinal lymph node, mild dull left groin ache, and nausea are consistent with inguinal lymphadenitis, which is an inflammation of the lymph nodes in the groin area. The patient's history of herpes could be a contributing factor, as herpes can cause lymphadenitis.
- Other Likely diagnoses
- Epididymitis: The patient's symptoms of groin pain and swollen lymph node could also be consistent with epididymitis, which is an inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm.
- Urinary tract infection (UTI): The patient's symptoms of nausea, lumbar pain, and groin pain could be consistent with a UTI, which is an infection that occurs in any part of the urinary system.
- Lymphogranuloma venereum (LGV): The patient's symptoms of swollen lymph node and groin pain, combined with their history of herpes, could also suggest LGV, which is a sexually transmitted infection caused by certain strains of the bacteria Chlamydia trachomatis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular torsion: Although the patient's symptoms do not strongly suggest testicular torsion, it is a medical emergency that requires prompt attention. Testicular torsion occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle.
- Appendicitis: The patient's symptoms of nausea, lumbar pain, and groin pain could be consistent with appendicitis, which is an inflammation of the appendix. Although the patient's symptoms do not strongly suggest appendicitis, it is a medical emergency that requires prompt attention.
- Ovarian torsion (in female patients): If the patient were female, ovarian torsion would be a potential "do not miss" diagnosis. Ovarian torsion occurs when the ovary becomes twisted, cutting off the blood supply to the ovary.
- Rare diagnoses
- Tuberculosis (TB) lymphadenitis: The patient's symptoms of swollen lymph node and groin pain could be consistent with TB lymphadenitis, which is a rare condition caused by the bacteria Mycobacterium tuberculosis.
- Cat-scratch disease: The patient's symptoms of swollen lymph node and groin pain could be consistent with cat-scratch disease, which is a rare condition caused by the bacteria Bartonella henselae.