ABSTRACT. Acute human immunodeficiency virus (HIV) seroconversion illness is a difficult diagnosis to make because of its nonspecific and protean manifestations. We present such a case in an adolescent. A 15-yearold boy presented with a 5-day history of fever, sore throat, vomiting, and diarrhea. The patient also reported a nonproductive cough, coryza, and fatigue. The patient's only risk factor for HIV infection was a history of unprotected intercourse with 5 girls. Physical examination was significant for fever, exudative tonsillopharyngitis, shotty cervical lymphadenopathy, and palpable purpura on both feet. Laboratory studies demonstrated lymphopenia and mild thrombocytopenia. Hemoglobin, serum creatinine, and urinalysis were normal. The following day, the patient remained febrile. Physical examination revealed oral ulcerations, conjunctivitis, and erythematous papules on the thorax; the purpura was

A 3-year-old boy with early rupture of an aortic aneurysm due to infantile Marfan's syndrome is presented. In an emergency operation we prepared a composite graft using a 17-mm St. Jude prosthesis with an 18-mm vascular conduit. The postoperative period was complicated by pneumothoraces, transient bilateral phrenic nerve paralysis, cerebral convulsion, and supraventricular tachycardia. Four months postop the composite graft was replaced with an aortic homograft due to severe stenosis. His condition after 12 months is excellent.

After replacement of a heart valve a pregnancy is possible in the complaint categories I and II. Treatment with anti-coagulation is necessary for plastic heart valves. To avoid teratogenic effects the early pregnancy is best managed with heparin although stillbirth and early intra-uterine death are more common than with Marcumar. A treatment with heparin 10,000 units subcutaneously twice throughout all of the pregnancy is recommended. According to the literature 2/3 of the pregnancy with anti-coagulation result in the normal delivery of a healthy infant. Of 202 women in the reproductive age group with artificial heart valves, 150 were followed by a questionnaire. 25 women desired children. 10 women had pregnancies. 1 had two pregnancies, 1 had three pregnancies, 3 healthy infants were born.

The modified maze procedure in combination with cardiac surgical interventions proved to be easy, quick and reliable to perform. The early results suggest a high success rate of this technique. The long-term results have to be verified with further, regular follow-up examinations of the patients.

Epstein-Barr virus (EBV) infection with associated acute acalculous cholecystitis (AAC) has been reported in 18 pediatric patients. Our case is that of a seven-year-old girl with acute EBV infection and associated AAC.