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A 17-year-old woman was admitted with sore throat, cervical lymphadenopathy and marked leukocytosis (white blood cell (WBC) count 36×109/litre, neutrophils 26×10×109/litre). She deteriorated over the next 5 days developing acute respiratory distress syndrome (ARDS) needing extracorporeal membrane oxygenation (ECMO) support. An MRI scan showed retropharyngeal lymphadenopathy and no mediastinal …
Competing interests: None.
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