A ten-year-old male patient presented with a one-week history of fever with bilateral marked odynophagia and edema of the lower extremities without edema in other locations.
Physical examination revealed hypertrophy, bilateral exudate, and small laterocervical adenopathies, in addition to the edema described.
Urinary sediment was performed and blood pressure values were normal.
Pharyngeal swab was taken and antibiotic treatment with oral amoxicillin was initiated for one week.
At the end of the treatment she returned to the doctor's office with fever for 12 days and asthenia.
No rash appeared after antibiotic administration.
The throat culture was negative for S. pyogenes.
On exploration, less cytomegalic edema and minimal hepatomegaly were detected because of the suspicion of monosomy B syndrome and hepatitis C, the decision was made to perform analytical control for hepatitis, liver profile and serology for hepatitis B.
Relative lymphocytosis (leucocytes 7480/μl with 68% lymphocytes), increased transaminase (GOT 125 IU/l, GPT 171 IU/l) and serology with positive IgM were found.
Seventeen days after the onset of the clinical picture, complete resolution of the hepatosplenic remission and normalization of the analytical control were found.
