An 11-year-old girl presented with asthenia, weight loss and fever for 13 days, with fever peaks every day, with no fixed schedule.
The examination showed asthenical habit (weight P3-10) and thick and whitish mucus in the cavum, with the rest of the normal examination.
On admission laboratory tests: leukocytes 4060/μl (segmented 59%, fallen 6%, lymphocytes 33%, monocytes 2%), Hb 13.3 g/dl, hematocrit 38%, platelets 25 000/μl.
In the smear urine sediment showed signs of helmet, activated lymphocytes and neutrophil vacuolization; CRP 58.1 mg/l (88.2 mg/l, in an emergency visit two days before); proteinuria.
She was admitted with intravenous amoxicillin-clavulanic acid treatment due to the smear findings and elevated acute phase reactants.
She remains afflicted since the second day of admission.
During her admission she presented micropetequias in the lower limbs and back of the feet on the second day, as well as bleeding of the oral mucosa presenting on the third day; in view of these findings and for presenting on the fourth day an analytical control 8000 platelet globulin/μl dose, a clinical response was decided to
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A fever study was performed without a long-standing focus, with positive IgM parvovirus B19, making diagnosis of parvovirus B19 infection, secondary platelet count and mild proteinuria, with rest of normal renal function.
