A previously well, developmentally normal 6-year-old Indian boy was admitted for evaluation of fever. He was first seen at our outpatient service at the onset of fever. At that time, upper respiratory tract symptoms of rhinorrhoea and nasal congestion together with bilateral non-purulent conjunctivitis suggested a viral aetiology. He was initially treated symptomatically but empiric antibiotics were started on day 4 of illness when his fever persisted and a leukocytosis of 19.7K/μL was noted on complete blood count. Haemoglobin (Hb) was 10.3g/dL and platelet counts were 554K/μL. It was thought that he might have an early acute bacterial sinusitis. A chest radiograph performed was also normal. He was admitted to hospital on day 7 of illness when his fever did not resolve despite the above measures.
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