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Old 07-02-2011
kemoo's Avatar
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Question Enlarged submandibular node + 6 mm PPD in a child ?

A 4-year-old child presents with an enlarged submandibular node that is 4 cm in diameter, non-tender, and not fluctuant. The node has been enlarged for about 4 weeks and there is no history of fever or contact with any person who was ill. A complete blood count (CBC) is normal, and a Mantoux test with 5 tuberculin units of purified protein derivative shows 6 mm of induration. Which one of the following is the most likely diagnosis?

a) cat-scratch fever
b) acute pyogenic lymphadenitis
c) acute lymphoblastic leukemia
d) tuberculous lymphadenitis
e) atypical mycobacteria lymphadenitis
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Old 07-02-2011
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My answer is E. but idk why
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m82_ghasemi (08-28-2011)
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Old 07-02-2011
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Mycobacterial infection Mycobacterial infections can present with lymphadenopathy alone, especially in the neck (scrofula). M. tuberculosis is the usual cause in adults; other mycobacteria, such as M. avium complex and M. scrofulaceum, account for most cases in children. Nodes are typically nontender, enlarge over weeks to months without prominent systemic symptoms, and can progress to matting and fluctuation.
You are right. Here is the description of UpTodate.
Others are generally tender or associated with local discoloration
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