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February 1994

Pathological Cases of the Month

Author Affiliations

From the Pediatric Division and Clinical Microbiology Laboratories, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.

Arch Pediatr Adolesc Med. 1994;148(2):209-210. doi:10.1001/archpedi.1994.02170020095018

A 6-YEAR-OLD BOY with cystic fibrosis presented to the hospital with low-grade temperature, cough, increased sputum production, and decreased appetite of 2 weeks' duration. Physical examination revealed a body temperature of 38.5°C, a respiration rate of 25 breaths per minute, a cardiac rate of 130 beats per minute, and a blood pressure of 105/60 mm Hg. The child looked pale and weak. Auscultation of the chest revealed decreased breath sounds and bilateral inspiratory and expiratory rales. Chest roentgenography showed a diffuse bilateral interstitial infiltrate, peribronchial thickening, and moderate hyperinflation. Oxygen saturation, while breathing room air, was 90%. Spirometry results showed a forced expiratory volume of 0.70 (59% of predicted), and a forced expiratory volume to forced vital capacity ratio of 80%. His total leukocyte count was lOXlO3mL. Culture of the sputum yielded Pseudomonas aeruginosa and Staphylococcus aureus. The patient was admitted to the hospital for treatment of acute