A 4-year-old previously healthy boy presented to a hospital with a 7-month history of a lesion on his face. Upon clinical investigation, left-sided cervical adenopathy measuring 3.5 × 2.5 cm was observed. However, the lymph nodes were not painful and were not attached to the overlying skin. The boy was treated with courses of erythromycin, amoxicillin-clavulanic acid, and cephalosporin but without any improvement. Furthermore, surgical drainage of the lymphadenitis performed 14 days post-illness resulted in a chronic draining fistulous tract.
The boy subsequently developed two more skin lesions, with the largest one measuring as 2.5 × 2.5 cm ( Fig. 1 ). What is the most likely diagnosis for this patient? Toxoplasmosis Scrofula and scrofuloderma Hodgkin lymphoma Cat-scratch disease (The answer is posted in the comment section below!) *This Case Challenge is from the Editorial Team of…
