Clinical History.—A 4-week-old infant girl was admitted to hospital with cough and rash since birth. She was well at birth, but with her first feeding became cyanosed and a cough developed. A chest roentgenogram showed right upper lobe pneumonia, for which ampicillin trihydrate and gentamicin sulfate were given. A maculopapular rash then developed. She continued to cough and was referred for the investigation of a presumed tracheoesophageal fistula.
The patient had a brother who died of thymic aplasia. In addition, there was a strong family history of consanguinity.
Physical Examination.—The infant was in distress and cyanosed. Respiratory rate on admission was 60/min, pulse rate was 160 beats per minute, and temperature 38.5°C. Systolic blood pressure was 60 mm/Hg. There was a diffuse maculopapular rash predominately over the genitalia, legs, scalp, and face. There was no lymphadenopathy. The chest was hyperinflated with poor air entry on the right side.
Young LW, Chandra RK, Dearlove J, Heneghan WD, Sprague WD, Kutty KM, Murphy D. Radiological Case of the Month. Am J Dis Child. 1978;132(6):621-622. doi:10.1001/archpedi.1978.02120310085019