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Annotated abstract

Unravelling the underlying febrile illness in an infant on chemotherapy: clinical picture

archdischild · 2026-03-11 · canonical JSON source

4 visible annotations · policy: published · automated confidence ≥ 75.00%

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A 2-month-old boy presented with bilateral group-E intraocular retinoblastoma diagnosed at 40 days of life. While he was admitted for cycle 2 of standard chemotherapy with vincristine, etoposide and carboplatin, his mother had a viral prodrome with myalgia, coryza and severe joint pain affecting the major joints. A week after chemotherapy, the baby experienced high-grade fever spikes and a faint erythematous blanchable generalised rash over the trunk, limbs and face, including a faint rash on the palms and soles. Investigations revealed pancytopenia (haemoglobin—8.1g%; total leucocyte count—1200*10∧9/L; neutrophils—10% and platelets—53*10∧9/L). Liver function tests showed transaminitis (alanine transaminase—695 U/L), and creatinine was normal. Blood cultures were sterile. The dengue NS1 antigen and a respiratory viral panel by PCR including influenza virus, respiratory syncytial virus and human metapneumovirus were negative.