Source:  Challenge    Tag:  cmv hiv

Here's a challenging case of a disease first described in 1972.

A 30 year old previously healthy woman presents with a low grade fever and fatigue for a week. Physical exam shows posterior cervical lymphadenopathy localized to one side and the rash shown above. The lymph nodes are 1-2cm in diameter, firm, smooth, discrete, and mobile. Labs show leukopenia and an elevated ESR. The following tests are negative: ANA, RF, EBV, CMV, HIV, and toxoplasmosis. She has no cat contact and has not been scratched (I knew you were thinking it). A biopsy of a lymph node is shown below.

Challenge: Luckily, this diagnosis is benign and resolves after 1-4 months. What is it?

First image shown under Fair Use. Second image shown under GNU Free Documentation License.