This is a 16 yo male originally presented to his PCP in April with c/o chest pain and low-grade fever that interfered with his normal daily activity. He was treated with NSAID and was immediately able to resume his regular schedule. On July 14th the patient had a 2nd episode of chest pain and low-grade fever. He was admitted to ????? where he underwent a pericardialcentesis and was treated with a brief course of IV steroids. Lab studies during his first admission were positive for RF and ANA and negative for M. pneumoniae, Lyme disease, coxsackie virus A or B, echovirus, heterophile antibodies, CMV and HIV. Bacterial, fungal and TB cultures were all negative and pericardial fluid showed 12,700 WBCs and 2000 RBCs. The pt was d/c pain free after a 3-day admission but presented again on 23 July for a 3rd episode of chest and low-grade fever. PMHx significant for episode of viral meningitis in 1997. PSHx significant for tonsillectomy/adenoidectomy and PET placement. FMHx is negative for both cardiac and rheumatologic disease. The pt is on no medications and denies illicit drug use.