Question

A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical history is notable for a similar hospitalization at 2 weeks of age. Physical examination is notable for a temperature of 102°F, oral thrush and rales in the right lung fields. Chest x-ray film reveals multilobular pneumonia. Given the history of recurrent severe infection, the pediatrician suspects an immunodeficiency disorder.

Explain the terms tachycardia, rales, and multilobular pneumonia.
What is the most likely immunodeficiency in this child? Why?
What is an underlying biochemical (genetic) defect in this patient?
Explain why this defect leads to the disease phenotype?
Explain the cellular defects associated with this disease?
What is the overall prognosis for patients with this disorder?

Answer 1

1) Tachycardia - Tachycardia is defined as increasing of the Pulse Rate above the normal Value..

Genarally if the Pulse Rate becomes more than 100 beats/ min.. Then It is Considered as Tachycardia..But here the child is 2 months Old ,, that means belongs to the catagory of infant..So, the normal pulse rate of a 2 months old child is 115-130 beats/min..

So,, In this case the 2 months Old Child Suffers from Tachycardia....that means heart rate is more than 115-130 beats/ min..

Rales - Crackles Or Rales are the abnormal Lung Sound that is heared in any kind of Respiratory Disease..This abnormal Sound is like rattling or Crackling Noise..

Multilobular Pneumonia - Multilobular Pneumonia is defined as an infectious condition which causes the inflammation of the parenchyma of lungs,,, that effect the multiple lobe of the Lungs..

It is a Very severe disease condition.. and it's Prognosis is worse..

2) In this Child the most likely Immunodeficiency is The presence Of Infection..

Because in this case the Child is in the Diagnosis of Multilobular Pneumonia..and the sign symptoms( Fever, Tachycardia, Oral Thrush, Rales ) which present in the child are the effect of any infection..

So, Here the immunodeficiency factor is Infection..

3)The presenting Underlining Genetic Defect may be-

• Immunodeficiency Disorder
• Poor diet & Nutrition
• Premature Birth
• Genetic Disorder like- Asthma, Sickle Cell anemia
• Congenital heart Disease Like- Atrial septal Defect(ASD), Ventricular Septal Defect (VSD) etc..

4) These genetic defect are Responsible for the Immunodeficiency Condition Of the Child..And that leads to lower immunity level..Which is responsible for initiating any Infection and then grow and development of this infection and also the infectious Disease ( In this Case Multilobular Pneumonia ) Rapidly..and in this way Disease phenotype is developed..

5) Three Cellular Stage   is Present in the Developing Of Pneumonia..

• Early Consolidation- Red Hepatisation is occured in this Phase due to excessive Collection Of the RBC, Fibrin etc..
• 2nd Phase Of Consolidation- Gray Hepatisation is Occured due to process of Active Phagocytosis..
• Resolution- This is the Last stage.. In This stage the intra-alveolar debris is removed..

6) The Prognosis Of Multilobular Pneumonia is Very Slow...Prognosis can be occured due to the proper medical Treatment,, Proper taking Of Medication & Also By the active Immunotherapy..