Infect Chemother.  2009 Jun;41(3):196-198. 10.3947/ic.2009.41.3.196.

Mediastinal Tuberculous Lymphadenitis with Periodic Fever

• Park CW
• Cheong HJ
• Song JY
• Jo YM
• Choi WS
• Kim MJ
• Kim WJ

• KMID: 1782324
• DOI: http://doi.org/10.3947/ic.2009.41.3.196

Abstract

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin's lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.

Keyword

Tuberculous lymphadenitis; Fever of unknown origin; Periodic fever

MeSH Terms

Antipyretics
Biopsy
Electrons
Fever
Fever of Unknown Origin
Hodgkin Disease
Humans
Inflammation
Mediastinum
Middle Aged
Necrosis
Renal Dialysis
Tuberculosis, Lymph Node
Antipyretics

Figure

• 

  Figure 1 A) Positron emission tomography (PET)/computed tomography (CT) scan reveals focal hot uptaking lesions in the mediastinum, B) conventional chest CT scan is taken and reveals a well-enhancing soft tissue lesion with internal low density areas are noted in the mediastinum including the subcarinal area.

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