Problem Case Diagnoses

A. The initial diagnosis of GERD in the 3-month-old male infant was confirmed by pH probe.

B. AP and lateral neck x-rays supported a diagnosis of adenotonsil-lar hypertrophy in the 3-year-old boy. During sleep, persistent oxyhemoglobin desaturation was treated with repositioning and supplemental oxygen therapy, maintaining oxyhemoglobin saturation levels in the 90-92% range. Clinical improvement occurred after urgent adenotonsillectomy.

Teaching Pearl: Question. What is the most common cause of severe apnea associated with viral infection?

VIII. Teaching Pearl: Answer. RSV; it can cause bronchiolitis and sometimes pneumonia in affected infants.

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