Case 19-1990

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Abstract
Presentation of CaseA 12-year–old boy was admitted to the hospital because of increasing fatigue and intermittent fever of one month's duration.The patient was a British citizen and had arrived in this country approximately two months earlier. He was in excellent health until one month before admission, while he was visiting in Yellowstone National Park, when fever and fatigue developed and continued for about three days. Increasing fatigue and fever recurred periodically thereafter while the patient was staying in Florida, and he experienced intermittent pain in the right shoulder that was not aggravated by movement. During the two weeks . . .