4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
12 years old female patient presented with history of recurrent bouts of chronic cough for past 2 yrs, each episode lasting for 10-15 days and subsiding on its own. Cough is so severe as to interrupt her sleep. Each episode is initially associated with hemoptysis whose severity decreases in 4-5 days. She also complains of dyspnoea on mild to moderate exertion. There is no history of weight loss nor has she any signs of malnutrition on examination. Physical examination is not contributory. Even there are no signs of pulmonary involvement on exam..Chest X-Ray shows milld hilar prominence. Hb is 12.4gm%,TLC is 8400, Dlc is P57%, L39%, E04%, absolute eosinophil count is 360 cells, bronchial washings showed aerobic cocci, and budding yeast cells. There is no response to antiallergic or bronchodilators.
Answer
Rule out cardiac disease such as mitral valve involvement. Also since she has hemoptysis, rule out pulmonary hemosiderosis. In this case send the BAL or sputum for macrophage laden hemosiderin analysis. Also rule out bleeding disorder. If all is negative, a CT chest with angiography may be required to rule out an arteriovenous malformation.
 
 
 
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