In 1982 a 32-year-old married bricklayer was admitted to a hospital in Rochester, New York, because of fever and subcutaneous nodules. The nodules were firm, 2 to 6 cm in diameter, and nontender and had appeared in the three weeks before admission. The patient's CD4+ lymphocyte count was 40 cells per cubic millimeter. During the first several days of hospitalization additional nodules appeared and the original nodules increased in size. Histologic examination demonstrated angioproliferation, and bacillary forms were identified in the lesions by Warthin-Starry staining, although standard bacterial cultures were negative. The patient was treated with oral erythromycin, and the.
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