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.