Diagnostic Dilemma


Author: Pediatric Oncall
An 11-month-old boy born of non-consanguineous marriage presented with a cough for 15 days and fever and breathlessness for 3 days. He had similar complaints at the age of 7 months and was hospitalized for same for 10 days and diagnosed as bronchiolitis and treated with IV antibiotics and nebulization. He was again hospitalized at 8 months of age for pneumonia and treated with IV antibiotics for 14 days. At that time, he was ventilated and bronchoalveolar lavage grew Klebsiella pneumoniae. He has had repeated episodes of cough and breathlessness and has been treated with antibiotics and steroids. On examination, the child had severe respiratory distress with decreased air entry on the left side. He was given nebulization, hydrocortisone but continued to develop stridor and difficulty in breathing. The child was then put under ventilator and condition improved. CT chest showed a retrotracheal bronchogenic cyst. The child underwent excision of the bronchogenic cyst and was alright after that.

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