Fever and an Abdominal Mass in an 18-month-old Boy
Year: 2020
Type: article
Study design: Case Report
Abstract: 1. Rachel L. Troch, MD*2. Suzanne Kochis, MD*,†
3. Aaron M. Milstone, MD, MHS*,‡
4. Sanjay Jain, MD*,‡
5. Howard Lederman, MD*,†
6. Anna C. Sick-Samuels, MD, MPH*,‡
1. *Department of Pediatrics,
2. †Division of Pediatric Allergy and Immunology,
3. ‡Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
An 18-month-old boy from Saudi Arabia presents with 4 months of vomiting, diarrhea, poor weight gain, and daily fevers. He also had a long-standing history of lymphadenopathy as well as an abdominal mass, for which evaluation and management had consisted of a nondiagnostic biopsy of the abdominal mass and multiple courses of empiric antibiotic and antifungal medications for a presumed infection. He continued to have daily fevers and a persistent mass so the family came to the United States for further evaluation.
His past medical history is notable for birth at 31 weeks’ gestational age via cesarean delivery due to maternal hypertension and subsequent hospitalization for 1 month without sequelae of prematurity. His immunizations are up to date according to the Saudi Arabia immunization schedule, including the oral polio and the Bacillus Calmette–Guerin (BCG) immunizations. (1) He developed a fever at 2 months of age for 3 days followed by the development of unilateral axillary lymphadenopathy, which never resolved and was persistent on presentation. The family history is notable for his parents being first cousins. They had had difficulty conceiving and experienced multiple miscarriages before the patient’s birth. He has no sick contacts, no animal exposures, and has not consumed unpasteurized foods.
On presentation, the patient …
Source: Pediatrics in Review
Institutions: Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W3090532285