RT Journal
A1 Bokulic RE, Beckerman RC, Mulvihill D, Wood BP
T1 RAdiological cases of the month
JF American Journal of Diseases of Children
JO American Journal of Diseases of Children
YR 1989
FD June 1
VO 143
IS 6
SP 747
OP 748
DO 10.1001/archpedi.1989.02150180129035
UL http://dx.doi.org/10.1001/archpedi.1989.02150180129035
AB A 22-year-old man with cystic fibrosis (CF) developed tachypnea, fever (temperature, 38.4°C), increased cough, and dyspnea. He also complained of a sore throat, generalized myalgias and arthralgias, diaphoresis, and chills. He was treated with nebulized tobramycin sulfate and oral ciprofloxacin hydrochloride. Bilateral wrist swelling and aching had begun 3 weeks prior to his respiratory symptoms. Because his pulmonary symptoms did not improve with outpatient therapy, the patient was admitted to the hospital.His vital signs on admission were a temperature of 36.8°C, a heart rate of 148 beats per minute, a respiratory rate of 28/min, and a blood pressure of 131/61 mm Hg. The physical examination revealed a barrel chest, diffuse crackles on auscultation, and severe clubbing of the digits. There was bilateral nontender swelling and deformity of the wrist (Fig 1).The laboratory results showed a white blood cell count of 10.7 × 109/L with 0.59 segmented