A boy frightened of going to bed and bumps in the night

doi:10.1136/bmj.b2787

Published 23 July 2009, doi:10.1136/bmj.b2787
Cite this as: BMJ 2009;339:b2787

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A boy frightened of going to bed and bumps in the night

C James, specialist registrar in paediatric intensive care ¹, A Gupta, specialist registrar in paediatric intensive care ¹, D Cheng, specialist registrar in paediatric oncology², S Padley, specialist registrar in radiology³, N Goulden, consultant in paediatric oncology ², S Skellett, consultant in paediatric intensive care ¹

¹ Paediatric Intensive Care Unit, Great Ormond Street Hospital, London WC1N 3JH, ² Department of Haematology, Great Ormond Street Hospital, London WC1N 3JH, ³ Department of Radiology, Royal Brompton Hospital, London SW3 6NP

Correspondence to: C James chrisjames@doctors.org.uk

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

An 8 year old boy of Indian origin presented to his local hospitalwith a three week history of worsening respiratory symptoms.He was previously fit and well, had not been febrile, and hisonly medical history was a recent visit to his general practitionerbecause he "found it hard to catch his breath at night." Hewas becoming increasingly scared of going to bed at night andhis mother was also concerned about some bumps that she couldfeel on his scalp while stroking his head in bed.

A chest radiograph was performed (fig 1).

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Fig 1 Chest radiograph

The decision was made to drain in theatre under general anaestheticwhat was assumed to be a right sided pleural effusion. Uponinduction, the patient became apnoeic and was difficult to ventilate.He then became asystolic and cardiopulmonary resuscitation wascommenced. Emergency bronchoscopy was required to establishan airway . . . [Full text of this article]

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