Faculty Teaching Tools: Chalk Talk Summary
✍🏽 This is a summary of a chalk talk developed by Molly Hillenbrand, MD — Vice Chief, Quality and Safety and Assistant Director of the Infectious Diseases Fellowship Program at Duke University.
Lymphadenopathy is a common ID consult, but it’s usually a clue, not the diagnosis. A structured approach can simplify what often feels like a broad and complex differential.
Start by organizing causes along two axes:
- Type of infection (viral, bacterial, mycobacterial, fungal, parasitic)
- Distribution (localized vs. generalized)
From there, let the history guide you. Pay close attention to illness tempo, systemic symptoms, travel, animal exposures, sexual practices, and immune status.
A few high-yield patterns:
- Localized, acute LAD → often viral or bacterial (URI, skin infection, Bartonella)
- Generalized or systemic LAD → consider EBV, HIV, TB, or endemic fungi
- Exposure-driven clues are essential (cats, travel, occupational risks)
Don’t forget:
- TB can present with isolated LAD: biopsy may be needed even with negative tests
- Persistent LAD warrants evaluation for malignancy or inflammatory disease
- LAD may be multifactorial, so reassessment after treatment is key
Bottom line: A simple framework—infection type × distribution, anchored in history—helps turn a broad differential into a focused one.
👉For the full chalk talk, examples, and teaching framework, visit the complete resource hosted by the IDSA Medical Education Community of Practice: Teaching & Learning Resources. Future chalk talk posts will include several smaller bites of multiple chalk talk summaries to encourage more learning!