History of frequent coughing

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A patient has been admitted to your pediatric intensive care unit. He is a twelve-week-old male who was transferred to your institution with a five-day history of frequent coughing. During these bouts of coughing the patient would frequently turn blue and expel massive quantities of mucus. Occasionally the coughing would be followed by vomiting. Shortly before admission the parents noticed the infant's coughing had become so severe that he lost consciousness several times. On admission the patient's pulse and respiratory rate were both highly above normal, but his chest radiograph showed no foreign masses and there was no evidence of an airway obstruction. His leukocyte count was 16,000/ul with 70% lymphocytes. Cerebrospinal fluid measurements were within a normal range. When the patient's throat was swabbed, no microbes could be grown on normal agar. His diet consisted primarily of breast milk, and occasionally honey. The patient's medical history revealed that he had received no immunizations. The father had recently returned from Western Uganda where he had been performing anthropological research on local populations in the area. Both parents had visited various parts of Africa over the previous decade.

Reference no: EM133716913

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