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July 1994

Pathological Cases of the MonthCase 1

Arch Pediatr Adolesc Med. 1994;148(7):723-724. doi:10.1001/archpedi.1994.02170070061011

A 10-MONTH-OLD white male infant was referred for the evaluation of progressive bilateral cervical lymphadenopathy of 4 months' duration. The parents gave the history of intermittent, low-grade fevers at home. He was initially treated with antibiotics without response. Lymphadenopathy continued to progress with additional involvement of the occipital, postauricular, and inguinal lymph nodes.

Physical examination revealed a well-developed, well-nourished infant in no distress. Bilateral cervical lymphadenopathy was quite obvious with the right side more pronounced than the left (Figure 1). Palpable inguinal, occipital, and postauricular glands of approximately 1.5×1 cm were also noted. The lymph nodes were matted, noninflamed, and firm in consistency. There was no hepatosplenomegaly.

Results of laboratory evaluation revealed a normal white blood cell count with a normal differential cell count, mild microcytic-hypochromic anemia with a hemoglobin concentration of 1.5 mmol/L and hematocrit, 0.30. The erythrocyte sedimentation rate was 52 mm/h and the platelet count was 53.7×1