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You are on night call in the hospital, and a nurse pages you to speak with parents who are concerned about their son’s clinical status. The patient is a previously healthy 2-year-old boy named Brian. You review your patient list and see that Brian was admitted yesterday for intravenous (IV) rehydration after experiencing fever, vomiting, poor oral intake, and diarrhea. The team caring for him attributed his symptoms to a viral infection. His nurse reports that his parents are concerned because, although his oral intake has improved, his fevers have not resolved, and he remains fussy. As you speak with the nurse, you begin to wonder if Brian’s symptoms reflect something other than a routine viral illness.

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