A 15-year-old girl presents to the clinic with fever, rash, and extremity pain associated with difficulty walking. The patient had been in her usual state of health until 6 days before admission, when she developed diffuse abdominal pain, nonbilious and nonbloody emesis, and subjective fever. The patient initially had been seen in the emergency department (ED) 2 days before presentation and underwent abdominal computed tomography (CT), blood work, and urine studies. The abdominal CT revealed a normal-appearing appendix and no evidence of gastrointestinal obstruction. The blood work was notable for the following: white blood cell (WBC) count, 18,700/μL (18.7 × 109/L) with 39% band cells; hemoglobin, 15 g/dL (150 g/L); hematocrit, 43.1; platelet count, 94.0 × 103/μL (94.0 × 109/L); erythrocyte sedimentation rate, 30 mm/h; and C-reactive protein, 111 mg/L (1057 nmol/L). The urinalysis revealed 0 to 5 WBCs, 2 to 5 red blood...

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