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Case Records of the Massachusetts General Hospital
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Volume 353:1387-1394 September 29, 2005 Number 13
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Case 30-2005 — A 56-Year-Old Man with Fever and Axillary Lymphadenopathy
Jane E. Koehler, M.D., and Lyn M. Duncan, M.D.

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Presentation of Case

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 trimethoprim–sulfamethoxazole was prescribed, without benefit. He was referred to a specialist in infectious diseases.

The patient did . . . [Full Text of this Article]

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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