A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen

John B. Darby, Chris A. Rees, Claire E. Bocchini, Andrea T. Cruz, Richard Kellermayer, Milton J. Finegold, Sarah E. Barlow

Research output: Contribution to journalArticle

Abstract

This is the case of a previously healthy, 11-year-old male of Indian descent who presented to the emergency department with a 2-month history of nausea, vomiting, diarrhea, fatigue, cough, and 7-lb weight loss. Acutely, he developed 5 days of fever as high as 39.4°C. He had a remote travel history to the Middle East. On physical examination, he was febrile and tachycardic, was thin but otherwise had a normal examination. His inflammatory markers were elevated: erythrocyte sedimentation rate was 93 mm/hour and his C-reactive protein was 25.4 mg/L. A complete blood count revealed a white blood cell count of 17 000 × 103/μL with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 × 103/μL. A chest radiograph was concerning for a cavitary lung lesion and an abdominal ultrasound revealed multiple hypoechoic lesions in his spleen. Our panel of experts reviews his case and examines the workup of this patient with diverse symptoms and focal findings on chest radiograph and abdominal ultrasound.

Original languageEnglish (US)
Article numbere20150155
JournalPediatrics
Volume137
Issue number3
DOIs
StatePublished - Mar 1 2016

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Cough
Diarrhea
Fever
Thorax
Spleen
Lung
Erythrocyte Indices
Middle East
Blood Cell Count
Blood Sedimentation
Leukocyte Count
C-Reactive Protein
Nausea
Physical Examination
Vomiting
Fatigue
Hospital Emergency Service
Weight Loss
Hemoglobins
Blood Platelets

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Darby, J. B., Rees, C. A., Bocchini, C. E., Cruz, A. T., Kellermayer, R., Finegold, M. J., & Barlow, S. E. (2016). A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen. Pediatrics, 137(3), [e20150155]. https://doi.org/10.1542/peds.2015-0155

A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen. / Darby, John B.; Rees, Chris A.; Bocchini, Claire E.; Cruz, Andrea T.; Kellermayer, Richard; Finegold, Milton J.; Barlow, Sarah E.

In: Pediatrics, Vol. 137, No. 3, e20150155, 01.03.2016.

Research output: Contribution to journalArticle

Darby, JB, Rees, CA, Bocchini, CE, Cruz, AT, Kellermayer, R, Finegold, MJ & Barlow, SE 2016, 'A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen', Pediatrics, vol. 137, no. 3, e20150155. https://doi.org/10.1542/peds.2015-0155
Darby JB, Rees CA, Bocchini CE, Cruz AT, Kellermayer R, Finegold MJ et al. A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen. Pediatrics. 2016 Mar 1;137(3). e20150155. https://doi.org/10.1542/peds.2015-0155
Darby, John B. ; Rees, Chris A. ; Bocchini, Claire E. ; Cruz, Andrea T. ; Kellermayer, Richard ; Finegold, Milton J. ; Barlow, Sarah E. / A case of an 11-year-old with cough, diarrhea, and findings of concern in his lungs and spleen. In: Pediatrics. 2016 ; Vol. 137, No. 3.
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