A PREVIOUSLY HEALTHY 2-year-old boy presented with a 7-month history of progressive obstructive sleep apnea and bilateral cervical lymphadenopathy despite intensive antibiotic therapy. His physical examination demonstrated enlarged tonsils and adenoids and bilateral cervical lymphadenopathy. His white blood cell count was in the upper range of normal, with slight lymphocytosis. He underwent a tonsillectomy, an adenoidectomy, and an excisional lymph node biopsy from the left posterior triangle. He tolerated surgery without incident and was discharged on postoperative day 1.