There were 12 girls and seven boys. All were white, with a mean age of 5-2 years (range 18-9-7 years).Results (Tables 1 and 2) Cervical nodes were the commonest affected (47%) followed by submandibular (31-5%) and preauricular (21%). In 16 (84%) of the children the lymphadenopathy was unilateral. Mean duration of swelling was 6-6 weeks (range 2 weeks-4 months). Appearance of the nodes varied but in 12 (63%) was suggestive of cold abscess with absent or minimal tenderness and fluctuation. Of the other seven, five (26%) had an appearance suggestive of bacterial abscess, one was cystic, and the other was a non-tender, mobile swelling. Glands varied from 1-5-7 cm in length. Two were described as a large mass, and three were fixed to underlying tissues. In one (case 16) infection developed after trauma to the area. Only two children had systemic upset. This was an intermittent fever and mild cough (case 1) and persistent cough (case 8).Routine haematology was unremarkable. One case had a raised white cell count (15 00Ox109/l 368 on 8 May 2018 by guest. Protected by copyright.

Cardiac aspergilloma is exceptionally rare with only a handful of cases reported and majority of them being in immunocompromised patients. Here, we present a case of cardiac aspergilloma involving the right and left ventricle in an immunocompetent patient that initially presented with acute limb ischemia. He was later found to have a cardiac mass with histopathological diagnosis confirming Aspergillus species. Despite aggressive medical and surgical interventions, the patient had an unfavorable outcome due to low suspicion of invasive fungal endocarditis given his immunocompetent status. Cardiac aspergilloma should remain in the differential diagnosis of immunocompetent patients as early clinical suspicion will result in early treatment and decreased mortality. Novel therapies are required to decrease mortality in the future from this fatal disease.