Case history
Case history
A 7-year-old boy with a cough and fever presents to his family doctor, accompanied by his father. He was well until 3 days ago, when he developed nasal stuffiness, a mild sore throat, and a productive cough with clear sputum. There has been no episode of trauma. He is fully immunized and has no medical history of note and no recent travel. His father reports that both the parents are heavy smokers. On examination, his temperature is 100.6°F (38.1°C), his heart rate is regular at 110 bpm, and his respiratory rate is 18 breaths/minute. Pulse oximetry shows an oxygen saturation of 96% on room air. There is mild erythema of the mucosa of the nose and posterior oropharynx. On auscultation, inspiratory rales are heard at the right lung base.
Other presentations
There is no universal presentation of childhood CAP. Most but not all children present with fever and cough.[4] Hypoxemia and increased work of breathing (as indicated by chest retractions, nasal flaring, or head bobbing) have been found to be the two signs most strongly correlated with radiographic evidence of pneumonia.[5] Tachypnea and tachycardia are nonspecific signs.[1] Grunting and cyanosis are signs of severe disease.[1]
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