Historical feature | Potential significance/examples |
Location, onset, adenopathy | Affects the most likely etiologies |
Local symptoms of infection |
|
Horner syndrome (miosis, ptosis, anhidrosis) or opsoclonus myoclonus | Neuroblastoma, rhabdomyosarcoma |
Constitutional symptoms (eg, fever weight loss, night sweats, arthralgias, skin rash) | May indicate malignancy, Mycobacterium tuberculosis, rheumatologic disease, or Kikuchi disease; fever is not helpful in discriminating infectious and noninfectious causes |
Dental problems or mouth sores | Anaerobic infection, actinomycosis, enteroviral herpangina, HSV gingivostomatitis, Langerhans cell histiocytosis |
Skin lesions or trauma | Staphylococcus aureus, GAS, HSV, cat scratch disease (Bartonella henselae), tularemia, bubonic plague (Yersinia pestis), diphtheria |
Exposures | |
Ill contacts | Viral respiratory infections, CMV, EBV, GAS, M. tuberculosis |
Unpasteurized animal milk | Brucellosis, Mycobacterium bovis |
Undercooked meats | Toxoplasmosis, tularemia |
Animals: | |
| Cat scratch disease, toxoplasmosis |
| Brucellosis |
| Tularemia |
| Bubonic plague |
| Mycobacterium marinum |
Tick bites, flea bites, biting flies or mosquitoes | Lyme disease, bubonic plague, tularemia, filariasis |
Travel | Depending on geographic region*, may increase risk of certain infections (eg, tularemia, bubonic plague, M. tuberculosis, measles, rubella, filariasis, leishmaniasis, typhoid fever) |
Sexual activity | Sexually transmitted infections; hepatitis B infection |
Past medical history | |
Medication history: Allopurinol, atenolol, captopril, carbamazepine, cephalosporins, gold, hydralazine, penicillin, phenytoin, primidone, pyrimethamine, quinidine, sulfonamides, sulindac | Associated with lymphadenopathy |
History of asthma | Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) |
History of recurrent infections, skin abscesses, suppurative adenitis | Chronic granulomatous disease |
Autoimmune disease | Autoimmune lymphoproliferative syndrome |
Immunization status | Diphtheria, measles, rubella (if not immunized) |
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