An 8-year-old girl referred by her pediatrician to the hospital for a one-week history of painful cervical adenopathy, with no response to treatment with amoxicillin-clavulanic acid.
No fever, asthenia, anorexia or other associated symptoms were reported.
On examination, left laterocervical lymphadenopathy less than 1 cm and lower laterocervical adenopathy 3.5 x 2 cm of hard consistency, not adhered, without associated inflammatory signs were observed.
Complementary tests showed normal blood count, biochemistry and coagulation, VSG 30 mm, negative antinuclear antibodies and rheumatoid factor.
PPD 5U negative.
Serology Herpesvirus 6 IgM positive.
Serologies CMV, EBV, ESR I-II, Hepatitis B and C, HIV, Toxoplasma gondii, Bartonella henselae, Parvovirus B19 and Salmonella typhi negative.
Chest X-ray and abdominal ultrasound were normal and cervical ultrasound confirmed lymphadenopathy.
Persistence of the adenopathies was performed open biopsy at 18 days of evolution.
The histological study showed foci of paracortical necrosis surrounded by CD4 and CD8 + T lymphocytes and abundant CD68+ histiocytes, intermingled with neutrophils and significant absence.
Auramine staining, mycobacterial culture, Enterovirus PCR, HSV, VZV, CMV, EBV and Herpesvirus types 6, 7 and 8 of the ganglionic tissue were negative.
The course of the disease was favorable and self-limited.
Two years later she is asymptomatic.
