PUZZLER
Infant girl in critical respiratory distress
Gordon Gray Still, MD, Pisespong Patamasucon, MD

THE CASE

IMAGE CREDIT/AUTHOR SUPPLIED

A healthy, 5-month old African American female presented to the emergency department with a 4-day history of cough, respiratory symptoms, high fever, poor oral intake, and abdominal distention. On the day prior to admission, the child began to have worsening tachypnea and increased work of breathing, also poor feeding and drooling. There was no vomiting or diarrhea.