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Subcutaneous Nodule and Diffuse Lymphadenopathy in a 6-Month-Old Boy From Africa—Diagnosis
Arch Dermatol. 2007;143(10):1323-1328.
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Diagnosis: Disseminated bacillus Calmette-Guérin (BCG) infection.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
The cutaneous papule and the lymph node showed the same pathologic features. The hematoxylin-eosin–stained sections demonstrated the presence of a granulomatous infiltrate with multinucleated Langerhans-type giant cells and calcified spherules resembling psammoma bodies or Schaumann bodies (Figure 2 and Figure 3). Fite-stained sections demonstratedthe presence of a few acid-fast bacilli (Figure 4). A mycobacterial culture of the lymph node was negative. On polymerase chain reaction testing, the lymph node was positive for Mycobacterium bovis BCG. A purified protein D test result was positive.
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One month after the patient started treatment with rifampin and isoniazid, the subcutaneous nodule resolved and the liver function test results were normal. The patient returned to Guinea and was not available for further follow-up.
DISCUSSION
Live, attenuated BCG vaccination is used to provide immunity against tuberculosis in countries with a high risk of infection. A review of . . . [Full Text of this Article]
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Subcutaneous Nodule and Diffuse Lymphadenopathy in a 6-Month-Old Boy From Africa—Quiz Case
Peter C. Friedman, Sameera Husain, David N. Silvers, and Maria C. Garzon
Arch Dermatol. 2007;143(10):1323-1328.
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