The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.
A 9-year-old boy is brought to the outpatient clinic by his parents with a 2- to 3-year history of intermittent fever, abdominal pain, failure to thrive, tiredness, and weakness. In between times of active illness, the patient is usually asymptomatic, although he gets tired very easily during his sporting activities. When present, the fever and pain usually subside on their own, but, occasionally, an antipyretic or a course of antibiotics is needed.
His weight has been constant with no significant height gain over the last year. He does not have any nausea, vomiting, diarrhea, constipation, bloating, or distention. No history of hematuria or stone disease is reported. He does not have any history of surgery, prolonged fever, hospitalization, or any illnesses (except for the present one). The family history is not significant. He has no known allergies, and his vaccinations are up to date. The patient comes from a poor socioeconomic background.
Medscape © 2015
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Arun Phophalia, Madhu Phophalia. Fever, Pain, and Failure to Thrive in a 9-Year-Old Boy - Medscape - Dec 16, 2015.