A 4-yr-old presenting with chronic cough and asymmetrical chest.

摘要: A 4‐yr‐old female was referred by her general practitioner with history of recurrent cough 18 months duration. The predominantly nocturnal no associated wheeze, fever or systemic symptoms and gastro-oesophageal reflux. There were exercise-induced symptoms. Asthma suspected she had been treated inhaled salbutamol significant improvement in chest infections, foreign body aspiration previous hospital admissions. On examination weight on the 3rd centile height 50th centile. cyanosis, clubbing ear, nose throat abnormalities. She a markedly asymmetrical less prominent right hemithorax compared left mediastinal shift to right. Breath sounds diminished side wheeze crepitations. rest cardiovascular normal. other abnormalities clinical examination. In view chronic failure thrive mantoux test, which strongly positive. bacille Calmette-Guerin vaccination at birth there recent contact tuberculosis (TB). sputum negative for Mycobacterium . given TBB chemoprophylaxis Isoniazid Rifampicin 6 months, during symptomatic cough. A radiograph (fig. 1⇓) computed tomography (CT) scan thorax (fig. 2⇓) revealed characteristic findings. Fig. 1.— Chest …