Management of a 16-Year-Old With Axillary Lymphadenopathy: The Cat's in the Bag

Abstract

Lymphadenopathy is a common presentation in primary care. The burden is placed on the provider to complete a thorough history and physical examination to choose proper diagnostic tests, if needed, to determine the diagnosis of and treatment for the underlying cause. It is of the utmost importance to determine if the cause of the lymphadenopathy is an infectious process or a malignancy that requires immediate referral. A case of lymphadenopathy in a 16-year-old boy that required three providers for diagnosis is presented. This patient moved through several referrals from primary care to specialty services to find the cause of his lymphadenopathy. The definition of lymphadenopathy, its common causes, and important findings on a history and physical examination for determining a diagnosis will be summarized in this article. In addition, the treatment of a common pathogen, Bartonella henselae, which was the cause of this patient's lymphadenopathy, will be described. It is of the utmost importance to determine if the cause of the lymphadenopathy is an infectious process or a malignancy that requires immediate referral. It is of the utmost importance to determine if the cause of the lymphadenopathy is an infectious process or a malignancy that requires immediate referral. Paige Johnson, Pediatric Nurse Practitioner, Hematology/Oncology Department, Children's Mercy Hospital, Kansas City, MO.