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Special Feature |

Acute Pulmonary Infiltrate in a 20-Month-Old Child—Quiz Case FREE

Efraim Bilavsky, MD; Jacob Amir, MD
[+] Author Affiliations

Section Editor: Albert C. Yan, MD
Assistant Section Editor: Samir S. Shah, MD


Arch Pediatr Adolesc Med. 2007;161(1):97-98. doi:10.1001/archpedi.161.1.97.
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A 20-month-old child had a 3-day history of grunting respirations, cough, and vomiting. He had been born at term by spontaneous vaginal delivery; the perinatal period was uneventful. He had been diagnosed with asthma at 6 months of age and had 4 recurrences of pneumonia, none of which required hospitalization. Chest radiography performed after the last episode of pneumonia revealed no abnormalities (Figure 1).

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Figure 1.

A chest radiograph taken 20 months prior to the current admission.

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On admission, the child was alert, smiling, and experiencing no toxic effects. Percutaneous oxygen saturation was 94% in room air, the rectal temperature was 37.4°C, and other vital signs were normal. Physical examination revealed mild dyspnea and tachypnea with grunting. There were diminished breath sounds in the left lower chest. The complete blood cell count was in the reference range. No leukocytosis or left shift was observed in the white blood cell count.

Figure 2 shows the chest x-ray film obtained on the day of admission.

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Figure 2.

A chest radiograph taken at the current admission.

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Figures

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Figure 2.

A chest radiograph taken at the current admission.

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Figure 1.

A chest radiograph taken 20 months prior to the current admission.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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