A 25-year-old woman was admitted for left jugular lymphadenopathy.
The only epidemiological history was numerous insect bites on a one-month trip to Mexico.
Physical examination revealed multiple adenopathies measuring 1 cm in diameter in the left laterocervical area, which were not painful, and the rest of the examination was normal.
Blood tests showed leukopenia (4,300 leukocytes/μl) with normal formula and LDH 372.
ANAS negative.
Serology for Bartonella henselae, Salmonella, Brucella, CMV, EBV, hepatitis B virus, C, rubella and RPR were negative.
Chest-abdominal computed tomography was normal.
Biopsy of left laterocervical adenopathy showed foci of paracortical necrosis with polymorphous inflammatory component, consisting of CD4+ T lymphocytes, CD 68 histiocytes, few plasma cells and absence of eosinophils.
The patient was successfully treated and remained asymptomatic two years later.
