Clinical History.—This 11-year-old white girl was first seen in consultation because of "calcium around her heart." She had been hospitalized because of three days of cough and high fever. She had not had chest pain, shortness of breath or symptoms of cardiac failure. Her family and personal history were not remarkable.
Physical Examination.—Her examination was normal except for a few rhonchi bilaterally. No murmurs, rubs, or irregular rhythm were noted on heart examination. Blood pressure was 120/80 mm Hg. Her liver could not be felt. The clinical impression was viral bronchitis.
Laboratory Data.—Her antistreptolysin O titer, febrile agglutinins, blood cultures, electrolyte values, sputum cultures, and blood counts were normal. Her old tuberculin skin test was negative, but the histoplasmosis skin test showed 12 mm of redness and induration. The histoplasmosis complement fixation was 1:80. The electrocardiogram was normal.
Interval Note.—The patient was lost to followup for