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PUZZLER Unremitting rash, neck masses complicate toddler’s diagnosis Anita K Pai, MD; Rajkumar Venkatramani, MD, MS; Michelle Thompson, MD THE CASE A 2-year-old boy presents to the emergency department with a persistent pruritic rash and a 4-week history of enlarging, tender, bilateral anterior and posterior cervical neck masses. The patient is eating and drinking normally, and he is able to breathe comfortably. He has not developed a hoarse voice, excessive drooling, or facial swelling. The family has no pets, history of foreign travel, or exposure to tuberculosis. What's your diagnosis?