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 (100F), 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.