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Assembly

Never Ending Wet Cough

Author
Paola Di Filippo
Department of Pediatrics at University of Study “G. D’Annunzio”, Chieti, Italy


Case

A seven-year-old girl presented to the hospital for an acute asthma exacerbation and subsequently developed respiratory failure, requiring ICU intervention. Her family history was negative for respiratory disorders and both parents were non-smokers who were in good health. She was born at term after spontaneous delivery but presented to the NICU in respiratory distress, which resolved with oxygen supplementation. Her past medical history included persistent mucous rhinitis from an early age and later, a productive cough that was unresponsive to antibiotics or inhaled steroids. Prior work-up included negative sweat chloride and CF genetic testing, negative allergy and immunology testing, and severe GERD in infancy. A representative slice of her chest CT scan is shown below.

representative slice of chest CT scan

Question

What does the CT image demonstrate?

A. Normal chest imaging
B. Interstitial thickening
C. Centrilobular nodules associated with some bronchiectasis in the basal segment of the lower left lobe
D. Nodularity of the left lower lobe

Answer