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A 12-year-old boy who was diagnosed with precursor B-cell acute lymphoblastic leukaemia developed a cough and coryza on day 8 of induction. Subsequent throat swab revealed infection with respiratory syncytial virus. He remained well and proceeded with the planned lumbar puncture and administration of intrathecal methotrexate under general anaesthetic. He represented with sudden onset of severe chest and upper back pain radiating to his neck with associated nuchal rigidity. His cough had persisted and intermittently …
Contributors CHN wrote the initial manuscript. CG provided input on the images. TW and NG were involved in the care of the patient and in the preparation of the final manuscript.
Funding NGG is supported by the Cancer Council of Western Australia Research Fellowship.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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