What is the likely diagnosis for a 66-year-old female with neck pain, a palpable and painful lymph node, and throat pain, with a history of sinus infection and recent flu-like illness?

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Differential Diagnosis for 66-year-old Female with Neck Pain and Palpable Lymph Node

Single Most Likely Diagnosis

  • Reactive Lymphadenitis: This condition is an inflammatory response to an infection or irritation in the throat, which could be caused by a viral or bacterial infection. The patient's symptoms of a painful and mobile lymph node, throat pain, and worsening pain with swallowing, along with a history of recent flu-like illness, support this diagnosis. The presence of morning mucous and intermittent dry cough also suggests an upper respiratory infection.

Other Likely Diagnoses

  • Tuberculosis (TB): Although less common, TB can cause lymphadenitis, especially with the patient's symptoms of night sweats and a dry cough. The absence of significant weight loss, fever, or chills does not rule out TB.
  • Streptococcal Pharyngitis: This bacterial infection can cause throat pain, swollen lymph nodes, and pain with swallowing. The patient's recent onset of symptoms and the presence of a painful lymph node support this diagnosis.
  • Sinusitis: Given the patient's history of a sinus infection, current symptoms could be related to sinusitis, especially with the presence of morning mucous and a dry cough.

Do Not Miss Diagnoses

  • Lymphoma: Although less likely, lymphoma can present with lymphadenopathy, night sweats, and systemic symptoms. Given the patient's age and duration of symptoms, lymphoma must be considered to avoid a delayed diagnosis.
  • Metastatic Cancer: A new onset of lymphadenopathy, especially in an older adult, warrants consideration of metastatic cancer, particularly from head and neck, lung, or breast primaries.
  • Thyroid Cancer: Thyroid cancer can present with a palpable lymph node in the neck, and the patient's symptoms of neck pain and a swollen lymph node could be related to thyroid cancer.

Rare Diagnoses

  • Sarcoidosis: This autoimmune disease can cause lymphadenopathy, but it is less common and typically presents with systemic symptoms such as fever, weight loss, and fatigue, which are not prominent in this case.
  • Castleman Disease: A rare lymphoproliferative disorder that can cause lymphadenopathy, but it is uncommon and usually presents with more systemic symptoms.
  • Kikuchi-Fujimoto Disease: A rare form of lymphadenitis, typically seen in younger women, which can cause lymph node swelling and pain, but it is less likely given the patient's age and clinical presentation.

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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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