<P><I>Editor’s note: Each month, this department features a discussion of an unusual diagnosis in genetics, radiology, or dermatology. A description and images are presented, with the diagnosis and an explanation of how the diagnosis was determined following. As always, your comments are welcome.</I></P> <P>A 3-month-old boy presented with a 4-day history of high-grade fever, irritability, watery yellowish stools, and decreased oral intake. He was the product of uneventful full-term pregnancy with normal vaginal delivery, and his birth weight was 3,200 g. Past medical history was positive for serous to greenish rhinorrhea since 2 months of age and aphthous stomatitis since 1 month of age. Dietary intake consisted of breastfeeding for the first 2 months of life, followed by an iron-fortified formula. His immunizations consisted of only a single dose of hepatitis B vaccine at birth. Family history was positive for early death of unclear etiology in four paternal uncles and one paternal aunt (see Figure 1).</P>
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