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In April 2009, a 5-year-old boy went on a holiday to Costa Rica. They visited the west coast (Guanacaste) and central highlands region (Arenal Volcano).
A week after their return to the UK, the parents noticed multiple lumps on the boy's scalp. Three nodules, about …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent Obtained.
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