Approach to peripheral lymphadenopathy (pediatrics) Quiz: Ace Your Exams

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A 17-year-old girl presents to the pediatrician with 3 days of fever and lymphadenopathy. The patient has not had a sore throat, rhinorrhea, or cough and has no known sick contacts. She has not been traveling. She volunteers at an animal shelter in her free time. She has no significant past medical history. Weight is 37^th percentile, height is 58^th percentile. Temperature is 38.2°C (100.8°F), pulse is 115/min, respirations are 16/min, blood pressure is 111/66 mmHg, and oxygen saturation is 98% on room air. After the physical examination, blood work is performed which is positive for Bartonella hensalae. Which of the following findings on lymph node examination would be most consistent with the underlying condition?

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Tender bilateral cervical lymph nodes

Generalized lymphadenopathy

Single tender erythematous cervical lymph node

Nontender supraclavicular lymph nodes

Immobile, nontender matted cervical lymph nodes