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Cough and Hurried Breathing for 5 days

Question:
Raghavendra H Gobbur, Keerthidarshini
Department of Pediatrics, Bijapur Lingayat District Education Deemed to be University, Shri B M Patil Medical College. Vijayapur, India.

Address for Correspondence: Dr Raghavendra H Gobbur, H.NO.110, K.H.B. Colony, Solapur Road, Vijayapur 586103, India. Email: rhgobbur@gmail.com

An 18 months old boy presented with cough and hurried breathing for 5 days. His symptoms had not been alleviated by over the counter cough remedies. There was no history of sudden choking while eating or holding an object in the mouth. There was history of pica. On examination, he had tachypnea, nasal flaring, intercostal and subcostal retractions, rales and air entry was diminished over left side of the chest as compared to the right side. Investigations showed hemoglobin 7.1g/dl, white cell count (WBC) 42430cells/cumm (82% polymorphs), platelets of 834000/cumm and mean corpuscular volume (MCV) of 52.7fl. Peripheral smear showed microcytic hypochromic anemia. Chest x-ray is depicted in Figure 1.

What is the diagnosis?