kpmle2
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A 3-year-old child presents with recurrent right lower lobe pneumonia. His growth parameters are at the 25th percentile, and he is developmentally appropriate for his age. His past medical history is positive for an ear infection at 18 months of age and gastroenteritis at 2 years of age. He has completed two courses of antibiotic therapy with minimal if any improvement. Which of the following conditions is most likely responsible for this patient's disease?
A: Primary B- or T-cell immunodeficiency disorder
B: Cystic fibrosis
C: Chédiak-Higashi syndrome
D: Congenital lung abnormality
E: Foreign body aspiration
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| hanialkhadher
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Foreign Body 
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| supra
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his growth is only at 25th percentile n has 2epidodes of infection n recurrent pnemonia .so i guess it cud be chediak higashi,combined t n b cell ruled out coz no oppurtunitic inf,cystic fibrosis no cuz not a typical picture,congenital lung abnormailty is remote only in one lobe.foreiign body is a possibility but does dat explain growth retardation,so i bet on chediak higashi,any other explanations?
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| me007
Forum Guru
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a.
not enough symptoms for Chédiak-Higashi syndrome, must be piripheral neuropathy, albinism, low platelets and family history
foreign body aspiration - should be not complete resolved pneumonia after treatment, not minimal improvement.
if you will post this q on step 1 forum, what whould you think will happen? 
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| sandra
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i think its foreign body aspiration. especially so, considering the location( rt lower lobe) . the child otherwise appears to be healthy, with the past history not marred with recurrent infections which would have been the case, had it been an immune deficiency. what do think guys?
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| darkhorse
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foreign body
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| neuroblastoma
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C-Chédiak-Higashi syndrome -disease is characterised by large lysosome vesicles in phagocytes (neutrophils), which thus have poor bactericidal function, leading to susceptibility to infections
There are several manifestations of Chediak-Hegashi syndrome ; however, neutropenia seems to be the most common. The syndrome is also associated with oculocutaneous albinism. Persons are prone for infections, especially with Staph. Aureus.
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