Presentation of Case A 15-year-old boy was admitted to the hospital because of fever of unknown origin, anemia, and weight loss. The boy was well until 40 days earlier, when he experienced the sudden onset of pain in the right upper abdominal quadrant, without nausea, vomiting, or diarrhea. He was examined on the same day by his pediatrician, who found no abnormality; the urine was reported to be normal. Three days later the temperature rose to 40.6°C, with persistent right-sided abdominal pain and cough. On physical examination the pharynx was red. The urine was normal. The hematocrit was 45 percent,.
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