What differentials would you think of in a 1 year 2 months old female child weighing 5 kg (Term, birth weight 1.5 kg) with appropriate feeding history and recurrent respiratory tract infections? other systemic diseases have been excluded. Chest X ray at present only shows increased bronchovascular markings.
Cystic fobrosis, Inborn error of metabolism aspiration, SMA, Dysplasia, Immunodeficiency
Let me clarify
No organomegaly
Higher function and other neurological features normal
Kidney function tests normal
No bony abnormality in skeletal survey....
I think it is reasonable to suspect Left to right shunt congenital heart disease, bronchial tree anomalies in addition to the differentials enumerated above
Left to right shunt, Admixture and transposition physiology, TOF with absent pulmonary valve, bronchial anomaly, cystic fibrosis, surfactant deficiency, kartagener syndrome and immunodefficieny state are possibility. Rarely some variety of tracheoesophagial fistula and foreign body aspiration can present like this.
Dr. Majumder thank you for such an elaborate answer.
Thanx to Dr. Mukhopadhyay and Dr. Sharma too.
Have a pleasant time.
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