Cough with rhinorrhoea

A 40-day-old boy was admitted to the Paediatric Department after a 2-week history of cough, rhinorrhoea, poor appetite, and deterioration of his general health condition. On arrival, the patient's temperature was 36.5℃ (97.7℉), respirations were 32 breaths/min, pulse was 130 beats/min, and blood pressure was 90/50 mmHg (50-75th percentile for his age). On physical examination, he appeared to be moderately ill. There was a moderate degree of inspiratory stridor, but normal oxygen saturation was noted. Inspection of the oral cavity showed a huge left peritonsillar swelling.

 

Examination

Laboratory tests revealed a white blood cell count of 11,950 (42% neutrophils, 42% lymphocytes, 10% monocytes, and 4% eosinophils) and normal electrolytes. The C-reactive protein (CRP) level was elevated at 9.2 mg/L. Treatment with intravenous ampicillin/sulbactam and gentamicin was initiated. On Day 3 of hospitalization, the patient was eating normally, and there was no inspiratory stridor on physical examination. A follow-up CT scan of the neck was performed after five days of intravenous antibiotic therapy.