Match each pediatric patient's clinical presentation of lymphadenopathy with the most likely causative infectious organism.
- A 3-year-old female patient is evaluated in the outpatient clinic for a progressively enlarging neck mass over the past three weeks. The lesion is a unilateral, submandibular lymph node that is non-tender, fluctuant, and features a distinct violaceous (purple) discoloration of the overlying skin. She is entirely afebrile.Mycobacterium avium complex
- A previously healthy 5-year-old boy develops rapid-onset swelling on the right side of his neck. Examination reveals a 4-cm anterior cervical lymph node that is acutely tender, erythematous, and warm to the touch. His temperature is ().Staphylococcus aureus
- An adolescent girl is seen at the student health center complaining of severe throat pain, profound fatigue, and swollen glands for the past week. Examination reveals bilateral posterior cervical lymphadenopathy, thick tonsillar exudates, and a palpable spleen edge below the costal margin.Epstein-Barr virus
- A 9-year-old male is examined due to a mildly painful lump under his right arm. His parents note the swelling appeared several weeks after they adopted a shelter kitten. A small, crusted erythematous papule is visible on the dorsum of his right hand.Bartonella henselae
Answer
The correct pairings map the violaceous subacute node to Mycobacterium avium complex, the acute warm node to Staphylococcus aureus, the systemic adolescent presentation to Epstein-Barr virus, and the axillary node with kitten exposure to Bartonella henselae.
Each pathogen produces a distinct syndrome of pediatric lymphadenopathy. Acuity, pain level, skin color changes, and exposure history (like a shelter kitten) are key differentiating factors in clinical diagnosis.
Step-by-Step Solution
Key Concept
Differentiating infectious etiologies of pediatric lymphadenopathy based on clinical acuity, laterality, skin changes, and systemic symptoms.