TY - T1的婴儿肺炎,失败to thrive and persistent radiographical changes JF - European Respiratory Journal JO - Eur Respir J SP - 172 LP - 176 DO - 10.1183/09031936.00113206 VL - 30 IS - 1 AU - Thompson, N. AU - Saglani, S. AU - Bush, A. Y1 - 2007/07/01 UR - //www.qdcxjkg.com/content/30/1/172.abstract N2 - A 9-month-old male presented to his local hospital with a 2-week history of diarrhoea and vomiting and a 48-h history of tachypnoea and grunting. He was afebrile on admission and oxygen saturation was 96% in room air, but he had mild respiratory distress and tachypnoea. Inflammatory markers were not raised but a chest radiograph showed left-sided collapse and consolidation. Treatment was commenced with i.v. antibiotics. The patient’s respiratory pattern worsened 24 h after admission and his oxygen saturation dropped to 90%, requiring 2.5 L·min−1 supplemental oxygen. His diarrhoea settled after 48 h but he continued to have intermittent vomiting. The patient was an only child, born at term to unrelated parents and had no significant illnesses until this episode. He had a complete immunisation history and was achieving his developmental milestones normally. Weight gain was along the 50th centile for the first 6 months but had dropped down towards the second centile since weaning had occurred. There was no other family history of note. After 2.5 weeks, he still had a significant supplemental oxygen requirement and persisting left-sided chest radiograph abnormalities, despite a change to broader spectrum antibiotics, and so was transferred to the Royal Brompton Hospital (London, UK) for a respiratory opinion. On arrival, he had no significant fever and over the next 4 days he became normally saturated in room air. Antibiotics were stopped as his clinical condition improved. Initial investigations on presentation were normal (table 1⇓), including white cell count differential and blood film. Early morning gastric washings were negative, as were Mantoux and sweat tests. Blood, urine and stool cultures, nasopharyngeal aspirate (NPA) for viral immunofluorescence and mycoplasma serology were all negative. Radioallergosorbent test for common allergens was negative as was a coeliac screen.View this table:In this windowIn a new windowTable 1— Initial investigations at presentation The patient remained mildly tachypnoeic, despite the absence of an oxygen requirement. A … ER -