Fever lasting 3 weeks, strabismus, coxitis and pneumonia in a 2-year-old boy: Sometimes children have lice and fleas
Abstrakt
A 2-year-old male patient presented with prolonged fever and clinical signs of pneumonia with dyspnea and low oxygen saturation. During the course of the illness the fever persisted and in addition, the patient refused to walk and developed an intermittent strabismus so that extended diagnostics were implemented.
Hip ultrasound examination showed a unilateral coxitis that was interpreted as being associated with an Epstein-Barr-Virus (EBV) infection, which was confirmed serologically. Due to the neurological symptoms an analysis of the cerebrospinal fluid was performed and showed mild pleocytosis and increased protein, compatible with a viral encephalitis.
Apart from EBV antibodies, further blood tests suggested an infection with tick-borne encephalitis (TBE).