Lisa Maurer, MD PhD, and Erika Friehling, MD, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA

A 3 year old boy with no significant past medical history was referred to the emergency department over 1-2 months with intermittent fevers (up to 102°F). This was associated with 2 weeks of worsening abdominal distension, but no abdominal pain. His appetite was described as normal. He had formed stools every 2-3 days (consistent with baseline) and normal urination. His parents were unsure if he had lost weight. Review of systems was otherwise negative. Specifically, he had no upper respiratory symptoms, rash, or neurologic complaints.

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