Abstract
A 75-year-old man presented with a history of fever and night sweats. One month earlier, he had been diagnosed with viral encephalitis and seizures and had been started on phenytoin. On examination, he was febrile with noother focal signs. Blood investigations revealed a raised white cell count (WCC) with eosinophilia, raised C-reactive protein (CRP), and mildly deranged liver function tests (LFTs). A gallium scan was performed and showed areas of increased uptake in the lungs in both hilar regions and the cervical region. On withdrawal of phenytoin, fevers and night sweats settled. CRP, WCC, and LFTs normalized and a clinically palpable left supraclavicular node resolved. A diagnosis of phenytoin-induced hypersensitivity reaction (pseudolymphoma syndrome) was made.
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