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A 6-year-old boy was referred to the paediatric infectious disease clinic with a 2-month history of enlarged, erythematous, painless cervical lymph nodes. He initially presented to his paediatrician with a painless lesion. At that time, he was treated empirically with clindamycin and azithromycin due to a history of cat exposure. Despite treatment, the lesion evolved into a non-healing linear ulcer with painless, ascending cervical lymphadenopathy. Serologies were negative for Bartonella henselae antibodies. Additional laboratory studies revealed eosinophilia and negative Toxoplasma gondii antibodies. After no improvement following a course of trimethoprim-sulfamethoxazole, further questioning revealed that the patient had fallen into a haystack 1 month before the initial cervical lesion. The patient's parents opted to treat the infection empirically for sporotrichosis with itraconazole rather than undergo lymph node biopsy. At the 2-week follow-up, his lymphadenopathy had resolved and had returned to baseline activity. © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Jordan Asher McKinney, Buse Baykoca-Arslan, Fatma Levent. Uncommon aetiology of lymphadenopathy in a healthy child: a sporotrichosis case with painless lymphadenopathy. BMJ case reports. 2022 Mar 04;15(3)

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PMID: 35246430

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