PUZZLER
Toddler with spiking fevers and persistent rash
LOWELL ROLLINS III, BS, MS3; EBONY BEAUDOIN, MD

THE CASE

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A 1-year-old boy with a 2-week history of fever and rash arrives at the emergency department for the second day in a row. Symptoms include repeat spiking fevers, rash, abdominal distention, and labs showing transaminitis. He is admitted for evaluation of fever of unknown origin.