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March 1970

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Arch Otolaryngol. 1970;91(3):306-309. doi:10.1001/archotol.1970.00770040412021

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PATHOLOGIC QUIZ CASE 1  Lawrence W. DeSanto, MD, and Edward C. Rosenow III, MD, Rochester, MinnA 3-year-old girl first began to cough late in February 1968. Noisy breathing and a low-grade fever accompanied the cough and vigorous antibiotic treatment did not change these symptoms. In March, intermittent wheezing developed and a second course of antibiotics was tried without benefit. A third course of antibiotics in April also failed to relieve these symptoms, and the diagnosis of whooping cough was considered. With the exception of the cough, she was well between these episodes.On May 17, a violent, short-term coughing paroxysm occurred while she was playing. This was followed by an audible wheeze. Over the course of a few hours the girl's temperature increased to 104 F (40 C). A thoracic roentgenogram (Fig 1) was made at this time. The fever subsided but the cough persisted. On June 22, during

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