Infectious Diseases in Critical Care Medicine

System PE ID findings Noninfectious mimics Diagnostic features

Posterior cervical
lymph-
adenopathy

1. Infectious
   mononucleosis


2. Rubella


3. HIV


4. Scalp infection


5. Toxoplasmosis


6. Trypanosomiasis


7. Neorickettsia
   sennetsu

l Castleman’s disease

l Kikuchi–Fujimoto disease

l Lymphoma

l 4. Metastatic cancer

l Tornwaldt’s disease

Culture/serology/biopsy.

CT scanning, if needed

Occipital
lymphadeno-
pathy

1. Rubella


2. Scalp infection


3. Toxoplasmosis


4. Cat scratch
   disease


5. Pediculosis


6. Tinea capitis


7. Tularemia


8. Orbital cellulitis

l Seborrheic dermatitis Culture and/or serology in

infectious causes. Scaling,

erythematous rash in

seborrhea

Supra-clavicular
lymphadeno-
pathy

1. Thoracic bacterial
   or fungal infections


2. Parinaud’s
   oculoglandular
   syndrome

l Metastatic cancer (GI, lung,

ovarian, GU)

l Lymphoma

Culture, imaging, biopsy.

Axillary
lymphadeno-
pathy

1. Upper extremity
   infections


2. Cat scratch
   disease


3. Brucellosis

l Lymphoma

l Breast cancer

l Melanoma

l Silicone implants

Culture, serology, biopsy.

Bicipital/epi-
trochlear
lymphadeno-
pathy

1. Upper extremity
   infections


2. Tularemia


3. Secondary
   syphilis


4. EBV

l Lymphoma

l Sarcoidosis

l SLE

Clinical setting. Culture,

serology, biopsy.

Inguinal
lymphadeno-
pathy

1. Infections of the
   foot/leg


2. STDs (syphilis,
   chancroid, LGV,
   genital herpes,
   granuloma
   inguinale)


3. Plague


4. Filariasis


5. Onchocerciasis


6. Rectal infections
   with CMV,
   mycobacteria


7. Tularemia


8. Cat scratch disease


9. EBV


10. Orchitis


11. Pediculosis


12. Intersphincteric
    abscess


13. Mayaro virus
    infection

l Metastatic cancer

(urogenital tract)

l Lymphoma

l Rosai–Dorfman disease

Clinical setting. Culture,

serology, biopsy.

(Continued)

Physical Exam Clues to Infectious Diseases and Their Mimics in Critical Care 55