Diagnostic Dilemma

Gastroenteritis, pleural effusion

Author: Pediatric Oncall
A 1 year 8 months old boy presented with fever and diarrhea for 3 days and vomiting for 1 day. On examination, he had dry mucosa with delayed skin turgor. Vital parameters and systemic examination was normal. He was diagnosed as gastroenteritis with some dehydration and treated with intravenous fluids and zinc supplements to which he responded. Subsequently he developed cough and chest X-Ray showed right lower zone pneumonia and minimal pleural effusion within 3 days of the gastroenteritis. His hemogram showed hemoglobin of 12.2 mg/dl, WBC count of 14,900/cumm (30% neutrophils and 69% lymphocytes) with normal platelet count. Mantoux test was negative.

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