Differential Diagnosis for Lymphadenopathy in an 18-year-old Male
Single Most Likely Diagnosis
- Infectious Mononucleosis: This is a common condition in young adults, caused by Epstein-Barr virus (EBV), which often presents with lymphadenopathy, fever, and sore throat. The age and symptoms of the patient make this a highly plausible diagnosis.
Other Likely Diagnoses
- Reactive Lymphadenitis: This condition occurs as a reaction to a viral or bacterial infection elsewhere in the body, leading to lymph node enlargement. It's common in young adults and can be triggered by various infections.
- Tuberculosis (TB): Although less common in some regions, TB remains a significant cause of lymphadenopathy worldwide, especially in areas with high prevalence. It can affect any age group, including young adults.
- HIV Infection: Human Immunodeficiency Virus (HIV) can cause lymphadenopathy, among other symptoms, during the acute infection phase or as part of the chronic disease process. Given the age and potential for recent exposure, this is a consideration.
Do Not Miss Diagnoses
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with lymphadenopathy. Although less common than infectious causes, missing a diagnosis of lymphoma could have severe consequences, making it crucial to consider and rule out.
- Leukemia: Acute or chronic leukemias can cause lymphadenopathy, and while they are less common, the potential for severe outcomes if not diagnosed promptly puts them in the "do not miss" category.
- Sarcoidosis: This autoimmune disease can cause lymphadenopathy, among other systemic symptoms. It's less common but can have significant morbidity if not recognized and treated.
Rare Diagnoses
- Castleman Disease: A rare disorder that involves an overgrowth of cells in the body's lymph nodes, which can cause lymphadenopathy. It's much less common than other causes but should be considered if more typical diagnoses are ruled out.
- Kikuchi-Fujimoto Disease: A rare, self-limiting condition that causes lymphadenopathy, typically in young women but can also occur in men. It's often diagnosed after other causes have been excluded.
- Kimura Disease: A chronic inflammatory disorder that can cause lymphadenopathy, more commonly seen in Asian males. It's rare and usually considered after excluding more common causes.