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PUZZLER
Boy with fever, cough, and oral lesions


J David Sterns, MD, Riva Kamat MD, FAAP

THE CASE

Credit: Author supplied

A previously healthy, 16-year-old Hispanic boy initially presents to the clinic with a 5-day history of tactile fevers, achy malaise, congestion, and a dry cough. He was afebrile with negative rapid strep and monospot tests, but was prescribed fluticasone, benzonatate, and ibuprofen for a presumed upper respiratory infection. He was encouraged to return if symptoms did not improve.

WHAT’S THE DIAGNOSIS?

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