0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Picture of the Month—Quiz Case FREE

Chun-Yi Lu, MD; Ping-Ing Lee, MD, PhD; Luan-Yin Chang, MD, PhD; Chung-Ming Chen, MD; Li-Min Huang, MD, PhD
[+] Author Affiliations

Section Editor: Albert C. Yan, MD
Assistant Section Editor: Samir S. Shah, MD


Arch Pediatr Adolesc Med. 2007;161(3):303. doi:10.1001/archpedi.161.3.303.
Text Size: A A A
Published online

A previously healthy, 10-year-old girl presented with 10 days of low-grade fever and bilateral, multiple cervical lymphadenitis. The enlarged lymph nodes were discrete, mildly tender, and with normal overlying skin. Her fever and cervical lesions persisted despite treatment with ampicillin-sulbactam. A chest radiograph was normal. Bacillus Calmette-Guérin (BCG) vaccine had been administered during the neonatal period. A tuberculin skin test with 2 U of tuberculin partial purified derivative (PPD) RT 23 SSI, 2 T.U./0.1 mL (Statens Serum Institut, Copenhagen, Denmark), was injected intradermally over the middle third of the right volar forearm. Erythematous induration over the tuberculin injection site appeared 24 hours postinoculation of tuberculin and peaked in size (25 × 22 mm) at 48 hours postinoculation. The induration became tender, and the erythema worsened. The evolution of the lesions is shown in the Figure. Results of a lymph node biopsy supported the diagnosis.

Place holder to copy figure label and caption
Figure.

Skin ulceration over right volar forearm in a 10-year-old girl with cervical Mycobacterium tuberculosis lymphadenitis. Pictures were taken serially at days 4 (A and B), 7 (C), 30 (D), and 90 (E) after the tuberculin injection.

Graphic Jump Location

Figures

Place holder to copy figure label and caption
Figure.

Skin ulceration over right volar forearm in a 10-year-old girl with cervical Mycobacterium tuberculosis lymphadenitis. Pictures were taken serially at days 4 (A and B), 7 (C), 30 (D), and 90 (E) after the tuberculin injection.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
JAMAevidence.com

The Rational Clinical Examination
Evidence Summary and Review 2

The Rational Clinical Examination
Detecting Pleural Effusion by Chest Radiograph