A Case of an 11-year-old With Cough, Diarrhea, and Findings of Concern in His Lungs and Spleen

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 × 10 3 /μL with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 × 10 3 /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. abstract Departments of a Pediatrics and b Pathology, Baylor College of Medicine/Texas Children's Hospital, Houston, TexasDr Darby contributed to the design and execution of the case conference, drafted and edited the original manuscript, and made revisions to the manuscript; Drs Rees, Barlow, Kellermayer, Bocchini, Cruz, and Finegold contributed to the design and execution of the case conference and reviewed and made revisions to the manuscript; and all authors approved the fi nal manuscript as submitted.

Crohn’s disease with pulmonary granuloma in a child: a case report and review of the literature

“…The keywords "pediatric", "Crohn's disease", and "pulmonary" were used to retrieve the associated literature from PubMed, and the reference lists of these identified studies were checked. The review identified 22 cases of CD with pulmonary involvement (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), which consisted of 10 males and 12 females, and the ratio of males to females was 1:1.2. The clinical manifestations, chest radiological features, and histological manifestations of these cases are summarized in Table 3.…”