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Picture of the Month—Quiz Case

Picture of the Month—Quiz Case An 11-month-old boy presented to the emergency department with a 24-hour history of barking cough and sudden onset of increased work of breathing. The family reported that his respiratory difficulty acutely worsened after a bout of forceful coughing shortly prior to arrival. On examination, the patient was ill appearing. His vital signs revealed a respiratory rate of 50 breaths/min and oxygen saturation of 76% on room air. The patient was in moderate respiratory distress, with grunting and retractions noted. There was no stridor. Auscultation of the chest revealed decreased breath sounds on the left. A portable chest radiograph was obtained (Figure 1). View LargeDownload Figure 1. Chest radiograph demonstrates pneumomediastinum with subcutaneous emphysema. Additionally, there is near-complete collapse of the left lung with associated leftward mediastinal shift. What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Picture of the Month—Quiz Case

Abstract

An 11-month-old boy presented to the emergency department with a 24-hour history of barking cough and sudden onset of increased work of breathing. The family reported that his respiratory difficulty acutely worsened after a bout of forceful coughing shortly prior to arrival. On examination, the patient was ill appearing. His vital signs revealed a respiratory rate of 50 breaths/min and oxygen saturation of 76% on room air. The patient was in moderate respiratory distress, with grunting and...
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Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpediatrics.2011.141-a
Publisher site
See Article on Publisher Site

Abstract

An 11-month-old boy presented to the emergency department with a 24-hour history of barking cough and sudden onset of increased work of breathing. The family reported that his respiratory difficulty acutely worsened after a bout of forceful coughing shortly prior to arrival. On examination, the patient was ill appearing. His vital signs revealed a respiratory rate of 50 breaths/min and oxygen saturation of 76% on room air. The patient was in moderate respiratory distress, with grunting and retractions noted. There was no stridor. Auscultation of the chest revealed decreased breath sounds on the left. A portable chest radiograph was obtained (Figure 1). View LargeDownload Figure 1. Chest radiograph demonstrates pneumomediastinum with subcutaneous emphysema. Additionally, there is near-complete collapse of the left lung with associated leftward mediastinal shift. What is your diagnosis?

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Sep 5, 2011

Keywords: mediastinal emphysema,chest x-ray,respiratory sounds,subcutaneous emphysema,work of breathing,chest,stridor,vital signs,mediastinal shift,oxygen saturation measurement,auscultation,dyspnea,cough,respiratory rate,respiratory distress,emergency service, hospital

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