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Archives of Disease in Childhood: Education and Practice Edition 2017-Sep

Unusual cause of dyspnoea.

Само регистровани корисници могу преводити чланке
Пријави се / Пријави се
Веза се чува у привремену меморију
Nicola Ullmann
Giulia Ceglie
Maria Giovanna Paglietti
Sergio Bottero
Renato Cutrera

Кључне речи

Апстрактан

A 4-year-old boy was admitted to our department with fever, cough and dyspnoea, unresponsive to salbutamol and antibiotic therapy. He had previously contracted bronchiolitis at 20 days of life, followed by intermittent episodes of wheeze that never required hospitalisation and responded to short inhaled corticosteroid cycles. He had an atopic family history. On examination, he had dyspnoea, persistent cough with bronchospasm but normal oxygen saturations. Bloods showed elevated eosinophils (2004 µL), a slightly elevated C-reactive protein (1.5 mg/dL) and total IgE (326 kU/L), and specific IgE was raised for various inhalant allergens (box). A chest X-ray was performed (figure 1).BoxPositive inhalant allergens Anthoxanthum odoratum Cynodon dactylon Dactylis glomerata Dermatophagoides farinae Dermatophagoides pteronissimus Holcus lanatus Poa pratensis Phleum pratense edpract;103/6/300/F1F1F1Figure 1Chest X-ray of the patient. QUESTIONS: 1. What does the chest X-ray in figure 1 show? interstitial pneumoniapneumothoraxlung atelectasis with mild mediastinal shiftdiffuse air trappingenlargement of right hilar lymph nodes 2. Given the clinical picture and the chest X-ray, what would your differential diagnosis include from the following? plastic bronchitis (PB)mycoplasma infectiontuberculosisforeign body aspirationlung perforation 3. Are any of these conditions not associated with a specific type of cast/PB? Fontan procedurehaemophilialymphatic abnormalitiesasthma and other allergic disorderssickle cell disease.

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