Non resolving pneumoniae
Author: krishanu mondal
Question.
A 5 months old girl born by non consanguineous marriage presented with low intermittent fever with cough and respiratory distress for last 15 days. She was term, normal delivery, neonatal period was uneventful. No previous major illness or hospitalisation. Vaccinated upto the age. No history of contact with tuberculosis.

On examination: heart rate-150/min, respiratory rate - 65/min
chest- bilateral crepitus and rhonchi heard. Intercostal and subcostal retraction were present. Other system examination revealed no abnormality.
Chest x ray showed bilateral dense infiltrates.
She was put on meropenem and teicoplanin. Nebulization and oxygen were also administered. Her condition did not improve with this treatment. Inj clarithromycin was also added after 3 days. But her condition worsened during the next 7 days, and she was put on mechanical ventilation.
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