A 30-year-old male with no previous history was admitted for fever and asthenia for 20 days.
On examination, in addition to fever (39 oC), she had a right supraclavicular lymphadenopathy of 1 cm in diameter and another three somewhat smaller in the right laterocervical region and lymphadenopathies of less than 1 cm in the left laterocervical region.
In the laboratory, the only notable data were a leukocyte rate of 3,500 with 40% lymphocytes and LDH of 626 U/L. PPD 5U was negative and the hemocultive, coprocultive and CMV tests were negative.
The cervicothoracic TAC showed the presence of bilateral cervical lymphadenopathies of up to 13 mm in diameter at the level of the right jugular-digastric chain and in the posterior axillary spaces of nonspecific character 1 cm.
Biopsy of a cervical adenopathy led to the diagnosis of paracortical necrotizing lymphadenitis with abundant karyorrhexis and mononuclear inflammatory cells.
Treatment was initiated with nonsteroidal anti-inflammatory drugs, with fever disappearing and being asymptomatic.
Currently she has been ten months without recurrence.
