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Pathological Case of the Month
Katherine Hsu, MD;
Trevena Moore, MD, MPH
From the Section of Pediatric Infectious Diseases, Boston University Medical Center (Dr Hsu), and the Department of Medicine, Children's Hospital (Dr Moore), Boston, Mass.
Arch Pediatr Adolesc Med. 2001;155:1173-1174.
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A 16-YEAR-OLD GIRL was seen for fever, headache, malaise, and right-sided chest wall pain of 1 week's duration. Prior to presentation, she developed a dry cough and nighttime sweating. On admission, her temperature was 38.8°C; pulse, 100 bpm; respirations, 20 breaths per minute; blood pressure, 114/75 mm Hg; and oxygen saturation, 95% breathing room air. She had dullness to percussion and decreased breath sounds over the lower  of the right posterior lung field. Upright and decubitus chest radiographs showed a free-flowing pleural effusion occupying  of her right lung field. Further questioning revealed she had emigrated to the United States from Haiti 4 months earlier and had negative findings on purified protein derivative (PPD) testing 3 months earlier. Her white blood cell count was 6800/µL (64% neutrophils, 3% bands, 17% lymphocytes, and 16% monocytes). Values for hematocrit and platelet count were normal; serum total . . . [Full Text of this Article]
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