A 4-year-old girl presented to the clinic with a chief complaint of a slowly enlarging mass in her right armpit for the past two weeks since she returned from a vacation from the USA. She has had no fever, but has had some loss of appetite. The mass was initially small and did not hurt; however, it has now grown to the size of an orange and has become painful. She cannot lower her arm due to the pain from the mass, and she carries her arm extended at 90 degrees to her body. Movement of her arm exacerbates the pain.
She came in contact with a 3 month old kitten at her relatives in the USA which was "rescued from a sewer. She got scratched 3 weeks ago on her right thumb. The scratch healed, but a small "wart" has developed in the line of the scratch. There is a scab on the wart and her mother has tried to squeeze the wart, but no pus has come out. Review of symptoms: …
