We read with interest the article that appeared in the May 24,1993, issue of the Archives,1 dealing with a case of tuberculous infection in a young man, manifesting by generalized lymphadenopathy, pulmonary infiltrates, and bone destruction.
We observed a somewhat similar patient described elsewhere.2
Report of a Case.
A 72-year-old man was admitted because of fever, abdominal pain, and weight loss. Prominent para-aortic and mesenteric lymph-node enlargement was detected by a computed tomographic scan and sonography. A chest roentgenogram was normal. Tuberculin skin test results were negative as were results of a sputum examination for acid-fast bacilli. The patient was suspected of having malignant lymphoma, and a surgical biopsy specimen of the abdominal lymph nodes revealed caseating granuloma and acid-fast bacilli in Langhans' cells. Subsequently, he was treated with three antituberculous drugs, with gradual resolution of his fever and progressive lymph-node calcification at follow-up sonography 1 year later.
Bernardeschi P, Bonechi I. Cutaneous Reactivity in Tubercular Lymphadenitis. Arch Intern Med. 1995;155(1):116. doi:10.1001/archinte.1995.00430010124021