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March 15, 2024

A 16-year-old girl is in the clinic for a follow-up for a fever. She has been having prolonged fever accompanied by fatigue,

A 16-year-old girl is in the clinic for a follow-up for a fever. She has been having prolonged fever accompanied by fatigue, night sweats, and loss of appetite. Her vital signs today are a temperature of 100.6°F, blood pressure of 110/72 mm Hg, heart rate of 102 bpm, respiratory rate of 17/minute, and oxygen saturation of 99%. On physical examination, she has an enlarged cervical lymph node on the right that is painless, rubbery, and firm. There is no hepatosplenomegaly. She is referred for excisional biopsy of the enlarged lymph node that shows large cells with a bilobed nucleus and pronounced nucleoli. Which of the following is the most likely diagnosis? Acute lymphoid leukemia Epstein-Barr virus infection Hodgkin lymphoma Metastatic adenopathy Mycobacterial infection

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