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Old 07-08-2011
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Question A 3 year old boy with enlarged submandibular node

A 3 year old boy with an enlarged submandibular node that is 4 cm in diameter, nontender, and not fluctuant. The node has been enlarged for about 5 weeks and there is no history of fever or any contact with any ill person. A CBC is normal and the PPD shows 6 mm of induration. Which of the following is the most likely diagnosis?

A. Cat-scratch fever
B. Acute pyogenic lymphadenitis
C. Tuberculous Lymphadenitis
D. Acute lymphoblastic leukemia
E. Atypical mycobacteria lymphadenitis
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Old 07-08-2011
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atypical mycobacteria/E?
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Old 07-08-2011
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Answe is E ...
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Old 07-08-2011
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B. Acute pyogenic lymphadenitis the answer i think

not TB even it is ppd>5 maybe because bcg vaccine
not ALL (cbc is normal)
not cat scratch( cause tender reginal LAP )

so iam confused between B and e
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Old 07-08-2011
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Here it is

A. Cat scratch fever has low grade fever, tender and fluctuating nodes

B. Acute pyogenic Lymphadenitis is caracterized by tender nodes that may fluctuate.
C. Tuberculous Lymphadenitis presents with fever, abnormal CBC and contact will ill person and induration is less than 10 mm
D. Acute Lymphoblastic leukemia may present as lymphadenitis but the CBC will be abnormal with blasts present on the peripheral smear
E. Is the answer Atypical Mycobacteria Lymphadenitis is caracterized by non tender lymphadenitis, affected people are afebrile with normal CBC and no history of contact with tuberculous individual
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Infectious-Diseases, Pediatrics-, Step-2-Questions

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