This is the case of a previously healthy, 11-year-old male of Indian descent who presented to the emergency department with a 2-month history of nausea, vomiting, diarrhea, fatigue, cough, and 7-lb weight loss. Acutely, he developed 5 days of fever as high as 39.4 degrees C. He had a remote travel history to the Middle East. On physical examination, he was febrile and tachycardic, was thin but otherwise had a normal examination. His inflammatory markers were elevated: erythrocyte sedimentation rate was 93 mm/hour and his C-reactive protein was 25.4 mg/L. A complete blood count revealed a white blood cell count of 17 000 x 10(3)/mu L with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 x 10(3)/mu L. A chest radiograph was concerning for a cavitary lung lesion and an abdominal ultrasound revealed multiple hypoechoic lesions in his spleen. Our panel of experts reviews his case and examines the workup of this patient with diverse symptoms and focal findings on chest radiograph and abdominal ultrasound.
展开▼
机译：这是先前健康的印度裔男性11岁男性的情况，他向急诊科就诊，具有2个月的恶心，呕吐，腹泻，疲劳，咳嗽和7磅体重减轻的病史。急性地，他发烧了5天，最高发烧到39.4摄氏度。他到中东旅行的历史很少。体格检查时，他发烧，心动过速，瘦弱，但身体检查正常。他的炎性标记升高：红细胞沉降速率为93 mm /小时，C反应蛋白为25.4 mg / L。全血细胞计数显示白细胞计数为17000 x 10（3）/μL，带增加。他的血红蛋白水平为8.8 g / dL，平均红细胞体积为81 fl。血小板为556 x 10（3）/μL。胸部X光片显示肺空洞病变，腹部超声检查显示其脾脏有多个低回声病变。我们的专家小组审查了他的病例，并检查了该患者的各种症状，并在胸部X光片和腹部超声检查中发现了病灶。
展开▼
