2. Case presentation
TD Pham (PTD) was a 10-month-old boy presented with six hours of increased work of breathing, rhinorrhea, and cough lasting for 2 days. Bruising around his right eye was a notable sign at the triage. His grandmother reported that the bruise of the right eye was seen several days after falling from the cot two weeks ago. No medical care was sought for the bruise. He also had a history of irritability and intermittent vomiting over the past two weeks. There was no history of bruising or bleeding, persistent fever, or loss of weight. Since developing increasing work of breathing that morning he had decreased oral intake, though ”normal wet nappies”. There was no history of allergies and immunizations were up to date.
He was the first child in the family. His father was a drug addict with a history of intravenous drug use (IVDU) during pregnancy. He was born at 33 weeks via Lower segment Cesarean section for a large antepartum hemorrhage. APGARS were 3 and 5 at 1 and 5 minutes respectively. He required intubation and ventilation for 4 hours and followed by 2 days of CPAP.