Case 33-1989

Presentation of CaseA 26-year-old woman was admitted to the hospital because of persistent fever, with diarrhea, leukopenia, thrombocytopenia, and hypoxemia.The patient was well until approximately four weeks earlier, when nausea, headache, myalgia, and watery diarrhea developed, and her temperature rose as high as 40°C. After symptoms of four days' duration she consulted a physician, who made a diagnosis of a "viral syndrome" and prescribed symptomatic treatment. Fever and diarrhea persisted, and vomiting occurred, with a sore throat and enlarged, tender cervical lymph nodes. Twenty days before admission she returned to her physician, who found that the temperature was . . .