Recurrent chest infection in a 5 year old boy

doi:10.1136/bmj.b945

Published 6 May 2009, doi:10.1136/bmj.b945
Cite this as: BMJ 2009;338:b945

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Recurrent chest infection in a 5 year old boy

A M Murdoch, medical student ¹, L P Thia, specialist registrar in paediatric respiratory medicine², A Gupta, specialist registrar in paediatric respiratory medicine², C L Hogg, consultant in paediatric respiratory medicine²

¹ University of Glasgow, Glasgow G12 8QQ, ² Royal Brompton Hospital, London SW3 6NP

Correspondence to: L Thia lthia@doctors.org.uk

The first 150 words of the full text of this article appear below.

A boy born at 38 weeks’ gestation presented with neonatalrespiratory distress requiring oxygen and was found to havedextrocardia. During the first few years of life he had persistentmucopurulent rhinitis, intermittent wet cough, and bilateralserous otitis media. He was treated with several courses oforal and intravenous antibiotics for respiratory tract infections.The chest radiograph (figure) was taken when he was 5 yearsold.

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Fig 1 Chest radiograph of 5 year old boy

1 Describe the abnormalities shown.

2 What is the likely diagnosis?

3 How else might such a patient present?

4 What screeningand diagnostic tests are available?

1 Dextrocardia, situs inversus, and patchy areas of bronchialwall thickening can be seen. The haziness in the right lowerzone may indicate consolidation.

2 The diagnosis is primaryciliary dyskinesia.

3 Patients may present with sinusitis,bronchitis, pneumonia,and otitis media¹ or with a history . . . [Full text of this article]