História clínica

14-month old male with history of pulmonary stenosis s/p open heart transplant one year prior, receiving Sirolimus, Tacrolimus, and Prednisone. He was admitted for persistent fevers. Lab studies revealed pancytopenia, positive Strep Viridans in blood culture, and rising EBV titers by PCR (120,900 one week prior to BM biopsy). Chest/Abd/Pelvis CT and PET showed extensive lymphadenopathy (bilateral cervical, mediastinal, and left abdominal para-aortic LN regions), as well as hepatosplenomegaly.