A Pediatric Patient With Ascites, Proteinuria, and Thrombocytopenia: A Rare Presentation for a Common Illness. Issue 12 (29th December 2021)

• Record Type: Journal Article
• Authors: Simpson, Samantha L.; Clarkston, Kathryn; Wurster Ovalle, Victoria M.; Reed, Jennifer L.
• Is Part Of: Pediatric emergency care. Volume 37:Issue 12(2021)
• Page Start: e1733
• Page End: e1734
• Publication Date: 2021-12-29
• Subjects: Infectious mononucleosis -- EBV -- thrombocytopenia -- proteinuria -- ascites; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000001900
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract: A 7-year-old female patient presented to our pediatric emergency department with 5 days of fever, sore throat, abdominal pain, vomiting, headache, and 2 days of periorbital swelling. Her initial laboratory evaluation revealed a negative monospot test, neutropenia, atypical lymphocytosis, and thrombocytopenia in addition to transaminitis and proteinuria. An abdominal ultrasound obtained identified hepatosplenomegaly, moderate ascites, acalculous cholecystitis, and a distended appendix with periappendiceal fluid. She was admitted to gastroenterology for further management with antibiotics and surgery and hematology consults. Ultimately, Epstein-Barr virus polymerase chain reaction was positive. This case highlights an atypical presentation of Epstein-Barr virus and the collaborative approach to diagnosis.