Dyspnea With Intermittent Cyanosis in a Neonate
Dyspnea With Intermittent Cyanosis in a Neonate
Editor's Note: The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions.
Background
A 17-day-old African boy is brought to an emergency department (ED) in his local area in respiratory distress. For the past 7 days, he has had a nonproductive cough, tactile fevers, rapid breathing, and poor feeding. His parents also note that on 2 occasions when he was short of breath, his lips and fingers turned blue. These episodes lasted less than 30 seconds, were self-resolving, and were not associated with any loss of consciousness. He has not previously seen a doctor. The parents state that they have brought the child to the ED because he seems to be worsening; the second episode in which the patient turned blue occurred earlier today. He is not taking any medications and does not have any known drug allergies. Both parents work as farmers in East Africa. He has 4 older siblings, all without any known medical conditions. The patient was born full-term and was delivered vaginally at home, without any complications. His birth size of 19.3 in (49 cm) and weight of 6.4 lb (2.9 kg) are normal. Of note, the patient received minimal prenatal care.
Editor's Note: The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions.
Background
A 17-day-old African boy is brought to an emergency department (ED) in his local area in respiratory distress. For the past 7 days, he has had a nonproductive cough, tactile fevers, rapid breathing, and poor feeding. His parents also note that on 2 occasions when he was short of breath, his lips and fingers turned blue. These episodes lasted less than 30 seconds, were self-resolving, and were not associated with any loss of consciousness. He has not previously seen a doctor. The parents state that they have brought the child to the ED because he seems to be worsening; the second episode in which the patient turned blue occurred earlier today. He is not taking any medications and does not have any known drug allergies. Both parents work as farmers in East Africa. He has 4 older siblings, all without any known medical conditions. The patient was born full-term and was delivered vaginally at home, without any complications. His birth size of 19.3 in (49 cm) and weight of 6.4 lb (2.9 kg) are normal. Of note, the patient received minimal prenatal care.
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