TY - JOUR T1 - PIcture of the month—quiz case AU - Burghardt L, Neuman MI, Capraro AJ, Volk MS, Nagler J Y1 - 2011/09/01 N1 - 10.1001/archpediatrics.2011.141-a JO - Archives of Pediatrics & Adolescent Medicine SP - 865 EP - 865 VL - 165 IS - 9 N2 - 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). SN - 1072-4710 M3 - doi: 10.1001/archpediatrics.2011.141-a UR - http://dx.doi.org/10.1001/archpediatrics.2011.141-a ER -