CLINICAL HISTORY.—This 3½-month-old girl was admitted to Children's Hospital of Los Angeles because of recurrent swelling in the area of the parotid glands and hardness to palpation of the extremities.
She was well until one month prior to admission at which time she developed swelling of the eyes and face. There was intermittent fever to 102 F (38.9 C). She gradually lost movement of the extremities and was irritable and lethargic. However, she ate and slept well. The family history and past history were noncontributory.
Upon examination, she was afebrile, well developed, and well nourished, but was irritable. The positive physical findings were marked firm swelling in the parotid areas, and the extremities were hard, firm, and tender to palpation. She did not like to move her limbs.
The pertinent laboratory findings were as follows: hemoglobin, 7.6 gm/100 cc; white blood cell count, 19,000 with a normal differential; erythrocyte sedimentation