Case: The patient was a 12-year-old African American male who presented to our hospital from a community hospital for further care of a worsening left-sided pneumonia. His mother reported a 3-week history of intermittent cough and fever at home before his community hospital admission. She had been treating these symptoms with over-the-counter cough remedies at home but became concerned because his symptoms were not improving. The patient also had diagnoses of idiopathic bronchiectasis and selective immunoglobulin (Ig) A deficiency (reported according to history). He had required hospital admission for bacterial pneumonia several times during his life, and he was well below the 1% mark for height, weight, and BMI for his age. At the community hospital, he was treated aggressively with weight-appropriate doses of ceftriaxone and vancomycin. Despite treatment, the patient’s symptoms had not improved. Repeat imaging at the community hospital demonstrated worsening status of his pneumonia. On admission to...
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01 July 2014
