A 6 year old boy presents with multiple lymph node enlargement since one month. He has associated muscle aches, anorexia and joint pains. He does not have any significant medical history. On examination, cervical, inguinal and right axillary lymph nodes were enlarged. He is well nourished with adequate height and weight for age. Investigations showed normal hematological parameters. ESR and CRP were normal. Chest X-ray and abdominal ultrasound were unremarkable.
Renal and liver functions were also normal. Sputum and gastric aspirates were negative for AFB on repeated occasions. Mantoux was negative and there was no history of contact with TB. ELISA for Toxoplasma, CMV, EBV and HIV were negative. Brucella agglutination was negative. A biopsy of the cervical lymph node was performed. Histopathology revealed liquefactive necrosis. AFB and PAS staining were negative in lymph node section.…
