Case 36-1998

Presentation of CaseAn 11-year-old girl was admitted to the hospital because of fever, hypotension, and azotemia.The patient had been in excellent health until four days earlier, when fever, headache, sore throat, stiffness of the neck, abdominal pain, and an abdominal rash developed. The results of laboratory tests performed three days before admission and subsequently are presented in Table 1 and Table 2. A rapid test for streptococcal antigens was negative. Two days before admission, amoxicillin and diphenhydramine were administered. A throat culture yielded non–group A, β-hemolytic streptococci. The symptoms persisted, the urinary output was low, and menses began. One day before . . .