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Radiological Case of the Month

Lionel W. Young, MD; Ranjit K. Chandra, MD, FRCP(C); John Dearlove, MD, FRCP(C); Walter D. Heneghan, MD; William D. Sprague, MD, FRCP(C); Kidaparambil M. Kutty, PhD; Donogh Murphy, MD
Am J Dis Child. 1978;132(6):621-622. doi:10.1001/archpedi.1978.02120310085019.
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Clinical History.—A 4-week-old infant girl was admitted to hospital with cough and rash since birth. She was well at birth, but with her first feeding became cyanosed and a cough developed. A chest roentgenogram showed right upper lobe pneumonia, for which ampicillin trihydrate and gentamicin sulfate were given. A maculopapular rash then developed. She continued to cough and was referred for the investigation of a presumed tracheoesophageal fistula.

The patient had a brother who died of thymic aplasia. In addition, there was a strong family history of consanguinity.

Physical Examination.—The infant was in distress and cyanosed. Respiratory rate on admission was 60/min, pulse rate was 160 beats per minute, and temperature 38.5°C. Systolic blood pressure was 60 mm/Hg. There was a diffuse maculopapular rash predominately over the genitalia, legs, scalp, and face. There was no lymphadenopathy. The chest was hyperinflated with poor air entry on the right side.

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