Persistent hypoxaemia and a headache in a previously healthy 11-year-old girl

Introduction An 11-year-old girl presented with headache, fever and hypoxaemia. Two months earlier, she suffered a mild COVID-19 infection but was otherwise healthy and family history was unremarkable. At presentation, other than hypoxaemia with a room air oxygen saturation of 87%, her physical examination was normal. Blood test results showed a white cell count of 23x109/L and an elevated C reactive protein level of 3.5 mg/L. Chest X-ray (figure 1) demonstrated a retrocardiac opacity. The patient was admitted with a presumed diagnosis of pneumonia for intravenous cefuroxime and oral azithromycin treatment. During admission, blood cultures, viral PCR panel, PCR for mycoplasma and evaluation for multisystem inflammatory syndrome in children were negative. Repeated pulse oximeter measurements showed room air oxygen saturation of 93%. The girl was discharged after 5 days of treatment, following the resolution of her fever and reportedly also her headache. Two days after discharge, she was...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Thorax Pulmonary puzzle Source Type: research