Burkitt lymphoma is an aggressive non-Hodgkin lymphoma. While kidney infiltration is well documented, acute kidney injury is an unusual presentation. Facial nerve palsy is even rarer. Here, we report a case of a 2-year-old boy with both of these unu- sual findings. He presented with acute kidney injury and bilateral nephromegaly. Two days later, he developed left-sided facial nerve palsy. Imaging showed enlarged cervical lymph nodes. Bone marrow biopsy confirmed Burkitt lymphoma. He was treated following the COG ANHL01P1 protocol, with initial significant clinical improvement. Despite this, his condition deteriorated due to septic shock, and the patient died. This case emphasizes that Burkitt lymphoma can present with unusual symptoms. Therefore, it is important that clinicians maintain a high index of suspicion in cases with unusual constellations of symptoms, such as acute kidney injury and facial nerve palsy.
