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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 339:1308-1317 October 29, 1998 Number 18
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Case 33-1998— A 29-Year-Old Woman with Necrotizing Lymphadenitis, the Nephrotic Syndrome, and Acute Renal Failure
Michael P. Madaio, and Robert T. McCluskey

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Presentation of Case

A 29-year-old woman was admitted to the hospital because of necrotizing lymphadenitis followed by the nephrotic syndrome.

The patient had been well until two months earlier, when axillary and inguinal lymphadenopathy developed, soon followed by swelling, pain, and redness in the left axilla. Cephalexin was administered, but the swelling and pain increased, with nausea, vomiting, and weight loss. One month before admission, a lymph-node biopsy showed necrotizing lymphadenitis. Three weeks before admission, amoxicillin–clavulanate was prescribed, but fever occurred, with worsening swelling and pain.

Ten days before admission, the patient was admitted elsewhere. Cultures of blood, sputum, and urine were negative. . . . [Full Text of this Article]

Differential Diagnosis

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Dr. Michael P. Madaio's Diagnosis

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