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Page 2/Case 04/01


PHYSICAL EXAM

She was uncomfortable and in mild distress with mild intercostal indrawing. The growth was appropriate. Heart Rate=60, RR=34, T=38.2, oxygen saturation 96% on room air. The significant findings on exam were: Decreased breath sounds on the left, and no crackles. She had a monophonic expiratory wheeze on the left. She had no clubbing. The rest of the physical examination was normal.

PRESENTED BELOW; an old xray for comparison (when the patient was diagnosed with bronchiolitis.)



ENLARGE this Xray.

PRESENTED BELOW; the more recent Chest X-rays.



ENLARGE the "AP view" LEFT Xray, or the "forced expiratory view" RIGHT Xray.

WOULD YOU CARE TO OFFER A DIFFERENTIAL DIAGNOSIS?



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