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DURING THE early fall, a previously healthy 10-year-old child had a fever (temperature, 39.4°C) and upper respiratory tract symptoms of cough and rhinorrhea. No abnormalities were seen on a chest radiograph. His fever persisted despite a 10-day course of clarithromycin. On reexamination the patient was found to have acute otitis media and sinusitis, which were treated with the combination drug, amoxicillin–clavulanate potassium for 10 days. He continued to have a low-grade fever, malaise, and exudative tonsillitis, and developed generalized lymphadenopathy, night sweats, and, abdominal, back, and flank pain 5 weeks after the onset of illness. Urine culture and Epstein-Barr Virus titers were negative. Abdominal radiographs showed no abnormalities, but an abdominal ultrasound examination showed cystic lesions in the liver. He was subsequently referred for further evaluation.
Rivera-Penera T, Nielsen K, Hall TR. Radiological Case of the Month. Arch Pediatr Adolesc Med. 1998;152(1):87–88. doi:10.1001/archpedi.152.1.87
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