Article Text
Summary
A 19-year-old, previously healthy woman developed a pruritic erythematous maculopapular rash on her bilateral palms and wrists, right-sided tender cervical lymphadenopathy and nightly fevers and headaches 5 days after returning from a 1-month trip to Cambodia. She presented 2 weeks after her trip due to ongoing nightly fevers to a maximum of 38.8°C. She was given empiric doxycycline for possible rickettsial disease, though an extensive infectious workup returned without positive findings. Lumbar puncture was performed on hospital day 4, and spinal fluid analysis was consistent with aseptic meningitis. On hospital day 5, core biopsy and fine-needle aspiration were performed on the largest anterior cervical lymph node. Her fever curve gradually improved, and she was discharged on hospital day 6. Results of the lymph node biopsy were finalized 5 days after discharge and were compatible with Kikuchi’s lymphadenitis. Symptoms had completely resolved on follow-up with infectious disease and rheumatology.
- dermatology
- haematology (incl blood transfusion)
- immunology
- tropical medicine (infectious disease)
- travel medicine
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Footnotes
Contributors NDT and ASP contributed equally to this manuscript. Together, we represented the primary care team for this patient and contributed to the planning, conduct and reporting of this manuscript. Ex authorship: NDT and ASP.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.