A boy with fever, cough and gross haematuria

Giorgio Cozzi, Massimo Maschio, Gabriele Poillucci, Marco Pennesi, Egidio Barbi

Research output: Contribution to journalArticle

Abstract

A 5 year-old boy presented with 2-days of fever and cough. On examination, he had mild dyspnoea and chest pain, with crackles and hypoventilation at the right lung base. Blood tests showed: WBC 39.1×109/L; N 28.9×109/L; Hb 11.3gr/dL; PLT 375×109/L; CRP 28.7mg/dL; ESR 41mm/h. Chest x-ray confirmed a pulmonary consolidation in the right lower lobe (figure 1), with an associated pleural effusion. Bacterial pneumonia was diagnosed and intravenous ceftriaxone 100mg/kg/die was started. The following day, he developed palpebral oedema and his urine became tea coloured. His blood pressure was 126/82mmHg (>99th percentile).1Serum creatinine rose from 0.45mg/dl to 1.09mg/dl (39.8µmol/L - 93.4µmol/L) and C3 was 9mg/dl (n.r. 90-180mg/dl). Urinalysis revealed gross hematuria and 3+ proteinuria, with microscopicy showing dysmorphic red blood cells with casts. Ultrasounds showed enlarged kidneys with increased echogenicity.

Original languageEnglish
JournalArchives of Disease in Childhood: Education and Practice Edition
DOIs
Publication statusE-pub ahead of print - Aug 28 2017

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Hematuria
Cough
Fever
Bacterial Pneumonia
Hypoventilation
Lung
Urinalysis
Ceftriaxone
Respiratory Sounds
Hematologic Tests
Tea
Eyelids
Pleural Effusion
Chest Pain
Proteinuria
Dyspnea
Edema
Creatinine
Thorax
Erythrocytes

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A boy with fever, cough and gross haematuria. / Cozzi, Giorgio; Maschio, Massimo; Poillucci, Gabriele; Pennesi, Marco; Barbi, Egidio.

In: Archives of Disease in Childhood: Education and Practice Edition, 28.08.2017.

Research output: Contribution to journalArticle

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abstract = "A 5 year-old boy presented with 2-days of fever and cough. On examination, he had mild dyspnoea and chest pain, with crackles and hypoventilation at the right lung base. Blood tests showed: WBC 39.1×109/L; N 28.9×109/L; Hb 11.3gr/dL; PLT 375×109/L; CRP 28.7mg/dL; ESR 41mm/h. Chest x-ray confirmed a pulmonary consolidation in the right lower lobe (figure 1), with an associated pleural effusion. Bacterial pneumonia was diagnosed and intravenous ceftriaxone 100mg/kg/die was started. The following day, he developed palpebral oedema and his urine became tea coloured. His blood pressure was 126/82mmHg (>99th percentile).1Serum creatinine rose from 0.45mg/dl to 1.09mg/dl (39.8µmol/L - 93.4µmol/L) and C3 was 9mg/dl (n.r. 90-180mg/dl). Urinalysis revealed gross hematuria and 3+ proteinuria, with microscopicy showing dysmorphic red blood cells with casts. Ultrasounds showed enlarged kidneys with increased echogenicity.",
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AU - Barbi, Egidio

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N2 - A 5 year-old boy presented with 2-days of fever and cough. On examination, he had mild dyspnoea and chest pain, with crackles and hypoventilation at the right lung base. Blood tests showed: WBC 39.1×109/L; N 28.9×109/L; Hb 11.3gr/dL; PLT 375×109/L; CRP 28.7mg/dL; ESR 41mm/h. Chest x-ray confirmed a pulmonary consolidation in the right lower lobe (figure 1), with an associated pleural effusion. Bacterial pneumonia was diagnosed and intravenous ceftriaxone 100mg/kg/die was started. The following day, he developed palpebral oedema and his urine became tea coloured. His blood pressure was 126/82mmHg (>99th percentile).1Serum creatinine rose from 0.45mg/dl to 1.09mg/dl (39.8µmol/L - 93.4µmol/L) and C3 was 9mg/dl (n.r. 90-180mg/dl). Urinalysis revealed gross hematuria and 3+ proteinuria, with microscopicy showing dysmorphic red blood cells with casts. Ultrasounds showed enlarged kidneys with increased echogenicity.

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