Key result
A 2-year-old boy presented with fever, cough, respiratory distress, and clinical signs of a right-sided pleural effusion after failing to improve on oral amoxicillin.
Case Report (n=1)
A case report describing a 2-year-old boy with severe respiratory distress and clinical signs of a pleural effusion or consolidation after failing initial oral antibiotic therapy.
Alerts clinicians to possible complications in pediatric pneumonia failing oral antibiotics; case reports leave optimal management open.
A previously well, fully immunised 2 year old boy presented to his general practitioner with a five day history of cough and fever. He was initially prescribed oral amoxicillin, which did not improve his condition. On examination, the patient was febrile, tachycardic, and tachypnoeic; he was also in respiratory distress and had markedly reduced air entry on the right side of the chest with stony dullness on percussion. Cardiovascular and abdominal examinations were unremarkable. Inflammatory markers were raised (white cell count 28×109/l−1 and C reactive protein 340 mg/l−1). A chest radiograph was taken (fig 1).⇓ Chest radiograph (posteroanterior view) ### Short answers
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Gupta et al. (2009) conducted a case report in Fever, cough, and respiratory distress (n=1). Oral amoxicillin was evaluated. A 2-year-old boy presented with fever, cough, respiratory distress, and clinical signs of a right-sided pleural effusion after failing to improve on oral amoxicillin.
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