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Correspondence to Dr Jonathan Derrick, Department of Paediatrics, Homerton University Hospital, London E9 6SR, UK; [email protected]
A 9-year-old girl presented with a 4-day history of fever, coryza, sore neck and throat. She was tachycardic, normotensive and had sore bilateral enlarged cervical lymphadenopathy with halitosis. A diagnosis of glandular fever was made, and she was admitted for observation and intravenous fluids.
Blood tests showed an elevated C reactive protein of 73 and monocyte count (2.22×109/L) and a positive monospot. Epstein-Barr virus (EBV) serology was performed and was positive for EBV IgM but negative for EBV anti-Epstein-Barr nuclear antigen (EBNA) IgG, confirming acute infection.
During her admission, she developed isolated...