RT Journal
A1 Burghardt L, Neuman MI, Capraro AJ, Volk MS, Nagler J
T1 PIcture of the month—quiz case
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2011
FD September 1
VO 165
IS 9
SP 865
OP 865
DO 10.1001/archpediatrics.2011.141-a
UL http://dx.doi.org/10.1001/archpediatrics.2011.141-a
AB 
An 11-month-old boy presented to the emergency department with a 24-hour history of barking cough and sudden onset of increased work of breathing. The family reported that his respiratory difficulty acutely worsened after a bout of forceful coughing shortly prior to arrival. On examination, the patient was ill appearing. His vital signs revealed a respiratory rate of 50 breaths/min and oxygen saturation of 76% on room air. The patient was in moderate respiratory distress, with grunting and retractions noted. There was no stridor. Auscultation of the chest revealed decreased breath sounds on the left. A portable chest radiograph was obtained (Figure 1).