A 22-month-old white boy with no past significant medical history presented to a pediatric facility in respiratory failure. Case history The patient was noted to be cyanotic, required intubation during the transport to the emergency. His parents stated that the patient had "cold symptoms" for 1 week prior to admission, but denied associated fever, vomiting, or diarrhea. No reported history of previous trauma or ingestion. The patient was born full term. No history of previous hospitalizations or surgeries.
Immunizations were not up-to-date. Development had been appropriate for age. The family denied recent travel or sick contacts. Medications present in the home were Tylenol, Motrin, and Klonapin. Physical exam Vital signs: Rectal temperature 98.5° F, pulse 137, respiratory rate 19/min on a ventilator, blood pressure 93/71 mm/Hg, Spo2 99% on FiO2 40%, weight 12.3 kg. General:…
