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Case Records of the Massachusetts General Hospital
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Volume 359:178-187 July 10, 2008 Number 2
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Case 21-2008 — An 11-Month-Old Boy with Fever and Pulmonary Infiltrates
Jason B. Harris, M.D., Ian C. Michelow, M.D., Sjirk J. Westra, M.D., and Richard L. Kradin, M.D.

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Presentation of Case

An 11-month-old boy was admitted to this hospital because of fevers and pulmonary infiltrates. One month before admission, a month after beginning a visit to India with his parents, daily fevers, with temperatures up to 38.9°C, developed, without localizing signs or symptoms. Before the family left for India, the boy's primary care physician gave him one dose of immunoglobulin intramuscularly for hepatitis A prophylaxis and prescribed mefloquine weekly for malaria prophylaxis. He was evaluated at an Indian health care facility, and amoxicillin–clavulanate was administered, but there was no improvement. On the sixth day after the onset of fevers, mefloquine was . . . [Full Text of this Article]

Differential Diagnosis

Infection with Mycobacterium tuberculosis

Other Causes of Chronic Multinodular Pneumonia

Chronic Multinodular Pneumonia as a Manifestation of Primary Immunodeficiency

Diagnostic Testing

Dr. Jason B. Harris's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Departments of Pediatrics–Pediatric Infectious Disease (J.B.H., I.C.M.), Radiology (S.J.W.), and Pathology (R.L.K.), Massachusetts General Hospital; and the Departments of Pediatrics (J.B.H., I.C.M.), Radiology (S.J.W.), and Pathology (R.L.K.), Harvard Medical School.



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