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A normally fit and active 15-year-old schoolboy presented with a 1-week history of productive cough, malaise, fainting, but no fever. He also reported pleuritic chest pain after repeated throwing of a ball 3 weeks previously. An initial diagnosis of pneumonia was made; chest x ray showed a likely parapneumonic effusion and antibiotic therapy was …
Competing interests: None declared.
Patient consent: Informed consent was obtained for publication of the person’s details in this report.