Medical Mystery of the Week

Because of the COVID19 pandemic, you are using telemedicine to interview and visualize your patients. The current case is that of a 35-year-old man who is complaining of periodic fevers that peak in about 5-7 days, decrease over the next 5-7 days, and then repeat the same cycle. His fever is associated with diaphoresis and an occassional rigor. He also notes a swelling in his left neck area which is readily seen in your interview. His past medical history is unremarkable and his vital signs at the time of your exam are normal. What is your diagnosis, what test(s) would you order to confirm your suspicions, and what treatment, if any, do you recommend? Also, what do you think he drinks that causes the neck swelling to hurt?

DIAGNOSIS: Hodgkin's disease.

With his permission, the editor has chosen to copy Zar C. Min's excellent response to this Medical Mystery Case. Dr. Min is from the University of Medicine 2, Yangon, Myanmor."