Lower Respiratory Disorders Case Study Asthma
Lower Respiratory Disorders Case Study Asthma
Lower Respiratory Disorders Case Study Asthma
History
Bradley is a 8-year-old boy who is seen in the ER. He has coughs and wheezes
frequently, several viral illnesses per year. First, and most severe episode, occurred
when he was 7 months old. He has had many courses of antibiotics over the last few
years for chest infections, also he has bulky, offensive stools. Now he is came with
asthmatic episode. His mother reports that last time he was nearly transferred to the
pediatric intensive care unit (PICU) with chest infection. He has developed a cold and
become acutely breathless and physician prescribed salbutamol inhaler hourly but
without much relief.
Examination
Bradley is sitting up in bed with a nebulizer in progress containing 5 mg salbutamol.
His Oxygen saturation on 15 L of oxygen on arrival is documented as 89 per cent. He
is quiet but able to answer questions with short sentences. His chest is hyper inflated
(increased anteroposterior diameter) and he is using his accessory muscles of
respiration. His respiratory rate is 60 breaths/min and he has marked intercostal and
subcostal retraction. On auscultation there is equal but poor air entry with widespread
expiratory wheeze. His temperature is 38.6_C. His pulse is 180 beats/min with good
perfusion. He is small (height ninth centile, weight second centile), pale-looking,
miserable and very dependent on his mother. He has finger clubbing. His abdomen is
mildly distended but non-tender.
Questions
1. What is the most likely underlying cause for this acute episode?
An:
The respiratory infection and the recurrent of this infection is the most likely
underlying cause for this acute episode.