Female patient, 16 months old, with no morbid history, presented with rhinorrhea, cough and fever two days before, indicating antipyretics and bronchodilator therapy
Five days later, the patient suffered from vomiting and respiratory distress. The patient came to the emergency department with fever (39.5° C axillary), an increase in respiratory activity, and a desire to swallow
On admission, the patient had a HR: 196/min, RR: 56/min, weakness and moderate respiratory distress, in addition to the abolition of pulmonary sounds in the left hemithorax with evident bronchophonia.
The rest of the physical examination was normal.
1.
Laboratory tests revealed a hematocrit of 29%, hemoglobin: 9.6 g/dl, leukocytes: 18.800/mm3 (25% bacilliform), ESR: 99 mm/h, CRP: 18.2 mg/dl (N).
A chest X-ray at admission showed left basal pulmonary consolidation and adjacent pleural effusion.
Pleural fluid showed leukocytes 9000/mm3, predominantly polymoronuclear (97%), glucose: 14 mg/dl, proteins: 5.4 mg/dl stool proceeded with pH: 7.03 and pleural fluid: 670 U/L.
Intravenous treatment with cefoxime and cloxacillin was initiated; within 48 hours, the presence of non-bestafil-producing influenza H was reported. The patient discontinued therapy in pleural fluid as well as in anti-ceptic medication.
The clinical evolution was favorable, becoming a girl after left FiO1 received at 48 hours, when a laboratory control showed hematocrit: 25%, hemoglobin: 8.2 gr/dl, leukocytes: 69500/mmHSV3 35%, without deviation
The H. influenzae strain was sent to the reference laboratory of the Instituto de Salud Pública de Chile where it was confirmed that it was a non-typable strain by screening for cocloaglutination (Phaibnala and anti-s antibodies, then serotype c).
The chest X-ray on the fifth day of hospitalization, soon after discharge, showed complete resolution of the pneumonic process continued outpatient treatment with amoxicillin up to 14 days.
In a 30-day follow-up, the child was asymptomatic, in an excellent general condition, and a chest radiograph was normal.
