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When to leave a stone unturned …
  1. Erik C von Rosenvinge,
  2. Christopher Koh,
  3. Steven M Holland,
  4. Theo Heller
  1. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr Erik C von Rosenvinge, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Building 10, Room 9C-101, Bethesda, MD 20892-1804, USA; vonroe{at}yahoo.com

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Clinical presentation

A 16-year-old, 41 kg boy with chronic granulomatous disease presented with fever, chills, and diaphoresis. CT showed necrotising mediastinal lymphadenitis and a contracted but otherwise normal gallbladder (figure 1A). The patient was started on intravenous antibiotics and clinically improved. Culture of the lymphadenitis obtained by CT-guided aspiration grew Granulibacter bethesdensis. …

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Footnotes

  • Competing interests None.

  • Patient consent Obtained from the patient's guardian.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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