@entity1188 in Acute XXXX .

@entity1 @entity341 @entity1188 @entity381 @entity4555 @entity490 @entity4539 @entity221 @entity130
BACKGROUND: The evaluation of a febrile @entity1 with acute @entity490 represents a frequent yet possibly challenging situation in the @entity341 ( @entity341 ). @entity1188 is an uncommon complication of @entity4539 , and may have a wide range of clinical presentations, from dramatic to more subtle. Its pathogenesis is still incompletely understood, yet it may be associated with the occurrence of transient prothrombotic factors. CASE REPORT: We report the case of a 14-year-old @entity1 who presented with @entity221 , sore throat, left upper quadrant @entity490 , and @entity381 , with no history of @entity130 . Laboratory tests revealed a markedly prolonged activated partial thromboplastin time and positive @entity4555 . Abdominal ultrasonography showed several hypoechoic areas in the spleen consistent with multiple @entity1188 . Magnetic resonance imaging eventually confirmed the diagnosis. He was admitted for observation and supportive treatment, and was discharged in good condition after 7  days. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Spontaneous @entity1188 should be considered in the differential list of @entity1 presenting with left upper quadrant @entity490 and features of @entity4539 ; the diagnosis, however, may not be straightforward, as clinical presentation may also be subtle, and abdominal ultrasonography, which is often used as a first-line imaging modality in pediatric EDs, has low sensitivity in this scenario and may easily miss it. Furthermore, although treatment is mainly supportive, close observation for possible complications is necessary.
