Differential Diagnosis for Night Sweats and Critical Lymphadenopathy
Single Most Likely Diagnosis
- Lymphoma: This is often considered the most likely diagnosis due to the combination of night sweats and significant lymphadenopathy. Lymphomas, such as Hodgkin lymphoma, can present with systemic symptoms including night sweats, fever, and weight loss, alongside lymph node enlargement.
Other Likely Diagnoses
- Tuberculosis (TB): TB can cause night sweats and lymphadenopathy, especially in the context of systemic infection. It's a common cause of these symptoms in regions where TB is prevalent.
- Infectious Mononucleosis: Caused by Epstein-Barr virus (EBV), this condition can lead to lymphadenopathy and systemic symptoms like fever and night sweats, particularly in young adults.
- HIV Infection: Acute HIV infection can present with lymphadenopathy and systemic symptoms including night sweats. It's an important consideration, especially in individuals with risk factors for HIV.
Do Not Miss Diagnoses
- Malignant Lymphoma Variants (e.g., Burkitt Lymphoma): Although less common, these aggressive lymphomas can present with rapid onset of symptoms and are critical to diagnose early due to their aggressive nature and need for prompt treatment.
- Sarcoidosis: While not typically life-threatening, sarcoidosis can cause significant lymphadenopathy and systemic symptoms. It's a diagnosis that should not be missed due to its potential for long-term morbidity if not managed properly.
- Endocarditis: Infective endocarditis can present with systemic symptoms including night sweats and may have associated lymphadenopathy, especially if there's an embolic phenomenon or immune complex deposition.
Rare Diagnoses
- Castleman Disease: A rare disorder that can cause lymphadenopathy and systemic symptoms, including night sweats. It's often associated with HIV infection but can occur in HIV-negative individuals as well.
- Kikuchi-Fujimoto Disease: A rare, self-limiting condition that causes lymphadenopathy, often accompanied by fever and night sweats. It's more common in young women and typically resolves without specific treatment.
- Brucellosis: A zoonotic infection that can cause lymphadenopathy, fever, and night sweats among other symptoms. It's rare in many parts of the world but should be considered in individuals with exposure to infected animals or their products.