Acute medicine
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A 25-year-old Caucasian flight attendant with an extensive travel history presented with night sweats, fevers, weight loss and axillary and supraclavicular lymphadenopathy. Apart from surgical breast augmentation, she had no past medical or surgical history. ⋯ Histological examination of an axillary lymph node core biopsy confirmed the diagnosis of silicone lymphadenopathy. This case illustrates the broad differential for acute painful lymphadenopathy in the context of global travel, and the use of targeted infection testing, early cross-sectional imaging and biopsy to arrive at an unexpected diagnosis.