Differential Diagnosis for 18-year-old with 3cm cervical lymph nodes 6 months after EB
- Single most likely diagnosis
- Infectious mononucleosis (IMN) due to Epstein-Barr virus (EBV): This is a common condition in young adults, and the timeline of 6 months after EBV infection fits with the possibility of lingering or recurrent symptoms, including lymphadenopathy.
- Other Likely diagnoses
- Reactive lymphadenitis: This is a common reaction to various infections, including viral or bacterial, and could be related to the EBV infection or another concurrent infection.
- Tuberculosis (TB): Although less common in some regions, TB is a significant consideration for lymphadenopathy, especially if the patient has been exposed or has risk factors.
- Toxoplasmosis: This parasitic infection can cause lymphadenopathy, particularly in immunocompetent individuals, and might be considered if the patient has been exposed to cats or undercooked meat.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma (Hodgkin or non-Hodgkin): Although less common, lymphoma is a critical diagnosis to consider due to its significant implications for treatment and prognosis. The presence of large cervical lymph nodes warrants thorough investigation to rule out lymphoma.
- HIV infection: Given the potential for lymphadenopathy in the context of HIV, especially during the acute phase, it's crucial to consider this diagnosis, particularly if the patient has risk factors.
- Rare diagnoses
- Sarcoidosis: This autoimmune condition can cause lymphadenopathy but is less common in young adults without other systemic symptoms.
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that causes lymphadenopathy, primarily in young women, and is often associated with systemic symptoms.
- Castleman disease: A rare disorder that can cause lymphadenopathy, often with systemic symptoms, and can be associated with HIV infection or other conditions.