infection * Characteristic Patient 1 (2) Patient 2 (3) Age, y/sex 28/M 52/F Country Spain Australia Signs and symptoms Fever No Yes Rash No Yes Adenopathy
Yes No Lymphangitis Yes No Headache Yes Yes Myalgia No Yes Chest pain Yes Yes Heart failure No Yes Eschar Yes; neck No Organism R.
A chest x-ray would be diagnostic, as the presence of bilateral hilar adenopathy
along with the other symptoms would be diagnostic of Lofgren's syndrome.
In our case, we studied a patient with systemic symptoms, submaxillary adenopathy
, and imaging explorations that initially guided toward a lymphoproliferative process.
The likelihood of infectious mononucleosis is increased with the presence of posterior cervical adenopathy
, inguinal or axillary adenopathy
, palatine petechiae, and splenomegaly, whereas the likelihood reduces with the absence of any lymphadenopathy.
For the lymph nodes, differential diagnoses include reactive adenopathy
, suppurative adenitis, metastatic adenopathy
, and lymphoma (Figure 4).
All patients who presented with cervical lymph adenopathy
were included in the study.
Of the principal diagnostic criteria, cervical adenopathy
is the least common.
Other common lesions were tubercular lesions like in anterior mediastinum adenopathy
(four), middle mediastinum adenopathy
(two), and paravertebral abscesses (three) in posterior mediastinum.
2,4) Clinically, this kind of presentation is also seen in tubercular adenopathy
and in lymphoma in this young age group.
A computed tomography (CT) scan of the abdomen showed extensive adenopathy
at the porta hepatis area (Fig.
To our knowledge, there is no case of spontaneous prosthesis rupture with palpable inguinal adenopathy
to be reported.
In addition to the multinodular goiter and left-sided cervical nodules, CT also demonstrated bilateral axillary adenopathy