A 14-year-old African American female with no prior medical history presented with a 4 week history of fever, fatigue, myalgias, cervical adenopathy, arthral-gias, and weight loss with presumed viral parotitis. A Monospot test was positive and a diagnosis of Epstein-Barr virus (EBV) infection had been made. Three weeks prior to admission she had developed painful oral ulcerations and fatigue with rash on the face, trunk, hands, and feet. On admission the patient was found to be essentially pancytopenic with bone marrow aspiration negative for malignancy.
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