CASE HISTORY & EXAMINATION
A 3-year-old boy presented to the pediatrics outpatient department with
a complaint of high-grade intermittent fever for 1 week and cough for 3
days. The patient also had a history of 4-5 episodes/day of non-bilious,
non-projectile vomiting and dull activity in the past 1 day. The patient
had a history of decreased oral intake. The patient had a history of
recurrent episodes of fever in the past which was managed with multiple
admissions.
The patient was born out of a consanguineous marriage. On examination,
he had dysmorphic facies, frontal bossing, a depressed nasal bridge, and
large ears. He was febrile (100◦F), maintaining
saturation at room air. The patient had signs of dehydration and also
had pallor. On auscultation of the chest, air entry was decreased on the
left side, with normal heart sounds and no murmur. The abdomen was soft
without organomegaly. Examination of other systems including the spine
was normal.