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A 56-year-old man was referred to the transplantation infectious-disease clinic because of a low-grade fever and left axillary lymphadenopathy.
The patient had received a cadaveric kidney transplant five years earlier for polycystic kidney disease. He had been in his usual state of health until three weeks before the referral to the infectious-disease clinic, when he discovered palpable, tender lymph nodes in the left epitrochlear region and axilla. Ten days later a low-grade fever, dry cough, nasal congestion, and night sweats developed, for which trimethoprimsulfamethoxazole was prescribed, without benefit. He was referred to a specialist in infectious diseases.
The patient did
Differential Diagnosis
Lymphocutaneous Infection in an Immunocompromised Patient
Travel
Environmental Exposures to Pathogens
Contact with Pets and Other Animals
Zoonotic Pathogens Transmitted from Cats to Humans
B. Henselae as a Zoonotic Infection
Clinical Diagnosis
Dr. Jane E. Koehler's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Division of Infectious Diseases, University of California at San Francisco, San Francisco (J.E.K.); and the Dermatopathology Unit, Department of Pathology, Massachusetts General Hospital and Harvard Medical School both in Boston (L.M.D.).
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