case_images: PMC6161692_01
case_images: Chest x-ray, prior to commencing treatment.
case_images: fped-06-00245-g0001.jpg
case_images: PMC6161692_01_fped-06-00245-g0001.jpg
case_images: F1
case_images: HRCT evidence of progressive bronchiectasis (see Figures 1, 2), growth and development was excellent (Weight and height 64th centile) with baseline FEV1 3.8 l (93.9%). He had previously cultured Staphylococcus aureus (SA) and PsA (non-mucoid) and had one admission in the previous 12 months, requiring a pulmonary optimization with intravenous Piptazobactam and Tobramycin following a period of wet cough and decline in lung function.
case_images: High resolution CT chest with contrast. Generalized bronchiectasis demonstrated.
case_images: fped-06-00245-g0002.jpg
case_images: PMC6161692_01_fped-06-00245-g0002.jpg
case_images: F2
case_images: HRCT evidence of progressive bronchiectasis (see Figures 1, 2), growth and development was excellent (Weight and height 64th centile) with baseline FEV1 3.8 l (93.9%). He had previously cultured Staphylococcus aureus (SA) and PsA (non-mucoid) and had one admission in the previous 12 months, requiring a pulmonary optimization with intravenous Piptazobactam and Tobramycin following a period of wet cough and decline in lung function.
case_images: MRI, coronal section of right ankle, T1 weighted image.
case_images: fped-06-00245-g0003.jpg
case_images: PMC6161692_01_fped-06-00245-g0003.jpg
case_images: F3
case_images: He was referred to an orthopedic specialist in a near-by provincial center where an MRI identified a suspected tumor in his distal tibia (see Figure 3).
case_images: PMC6161692_02
case_images: PMC6161692_03
case_images: AP x-ray of right lower leg, cannulated screws transfix the fibular bone graft to the distal right tibial diaphysis.
case_images: fped-06-00245-g0004.jpg
case_images: PMC6161692_03_fped-06-00245-g0004.jpg
case_images: F4
case_images: Four months after diagnosis he underwent distal tibial resection and free fibula flap reconstruction (see Figure 4) which he recovered well from, requiring repeat bone graft to the right tibia 6 months later.
case_images: Percentage of predicted FEV1 at baseline, diagnosis, during chemotherapy and 12 months following completion.
case_images: fped-06-00245-g0005.jpg
case_images: PMC6161692_03_fped-06-00245-g0005.jpg
case_images: F5
case_images: Pulmonary function improved during his treatment from baseline (see Figure 5) with FEV1 4.15 l (102.3% predicted) whilst nutritional status remained stable with weight 64.1 kg (62nd centile).
case_images: PMC6161692_04
case_images: PMC6161692_05