A 4-year-old male child was referred to the hospital from a district hospital to further evaluate recurrent chest infection and wheezing. He was admitted to the referring hospital eight times for chest infection in the first 2 years of his age. The first admission happened at the age of 2 weeks. Cough, fast breathing, and wheezing were the main presenting symptoms during the exacerbations. At each admission, he was treated with parenteral antibiotics and bronchodilators and was discharged from the hospital after he got improvement. He was apparently healthy in between the episodes of the respiratory illness. He did not have a history of choking episodes. He was delivered in a hospital at term, and pregnancy was uneventful. He had optimal development and was a kindergarten student at the time of writing this report.
Examination
On examination, he was not in respiratory distress, and SPO2 was 94%–96% with room air. He weighed 14 kg, with a height of 106 cm (his anthropometric indices lie above –2 SD except for his weight-for-height, which lies between –2 and –3 SD). Chest examination revealed trachea shifting to the right side, decreased air entry over the right lung field, and relative dullness over the same area. Cardiac auscultation revealed normal heart sounds with a regular rate and rhythm with no gallop. He was alert and playful, having good interaction during the examination.
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