Monira is 7 year old Asian girl who presents to the pediatric rapid referral clinic a baby. With a lump on the side other neck. Her mother noticed it a week earlier, it is not painful she has had no fever night sweats or weight loss. Her mother state that about 4 weeks ago she had a cold that lasted for 2 days and was not accompanied by a temperature. Monira had the BCG vaccine when she was they no history of contact with TB .There has been no travel in the last 6 months
EXAMINATION
She’s apyrexial
4*3 cm lump on the left side of the neck, it’s not crythematous worm or tender, it’s mobile and not attached at the skin.
Less that 1 cm lymph node on the right side of her neck, no lymphadenopathy, no hepatosplenomegaly.
BCG scar is seen, ear, nose and throat appear normal
What is the differential diagnosis at presentation (prior to investigation?)
What you administer any treatment at the first visit
What is the mostly likely diagnosis following investigation
What cause of action would you follow if there was no change in the size of the lump after 10 days?
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