CASE FOR DIAGNOSIS Pulmonary mass in an infant

A Caucasian young female born at term weighing 3.4 kg, presented to her general practitioner at 4 weeks of age and repeatedly after that with cough, fever and ‘‘noisy breathing’’. She was treated with multiple courses of oral antibiotics. The symptoms persisted, and at 6 months of age a chest radiograph (CXR) showed dense consolidation affecting the right upper lobe. She was admitted to her local hospital for a course of intravenous antibiotics. The patient was afebrile on admission and oxygen saturation was 96% in room air, but she had mild respiratory distress and tachypnoea. Auscultation of the chest revealed scattered crepitations and transmitted sounds. Haematological indices and inflammatory markers were normal.