A 37-year-old male patient who had undergone renal transplantation presented with a 1-week history of a persistent fever (temperatures to 39°C). Physical examination revealed an ulcerated nodule over the right second metacarpal bone (Figure 1) and a 5-cm, firm, tender lymph node in the right axilla. The nodule developed in a scratch the patient had gotten while working in his rose garden. His adult cat had subsequently licked the wound. Excisional biopsy specimens were obtained from the cutaneous nodule (Figure 2) and the lymph node (Figure 3). The lymph node specimen was also stained with the Warthin-Starry silver preparation.
Boyce S, Peña JR, Davis DA. An Ulcerated Nodule Associated With Lymphadenopathy. Arch Dermatol. 1999;135(8):983-c-988. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-8-dof0899