1. cause of income
lactante of revenue a month for respiratory difficulty
BACKGROUND
Perinatal: second pregnancy well controlled 38 +5 weeks. part distocic (forceps). Apgar
9/10. weight 2910g. height 50cm. 32.5 cm pc. artificial lactation.
PERSONAL AND PATHOLOGICAL:
-no known allergies.
-not yet started the vaccination schedule.
income-to-day life for 11 influenza-like illness (confirmed influenza A in
nasopharyngeal swabs) during admission objective buf pansistolic sternal edge down to
membranous VSD (+ CIA-OS) to CE Controlled ........ currently takes frosemida.
spironolactone and captopril. Gaining weight.
FAMILY:
Without interest.
medication
frosemida. Spironolactone and captopril.
current process
Refer cough of 7 days of evolution that has worsened in the last 24 hours. In addition,
copious nasal mucus. Afebrile. no other simtomatologia. Epidemic negative
atmosphere. detected in CAP crepitans bibasals subcostal retractions and intermittent.
physical examination
FC 162 bpm FR 60rpm TA .......
Axi temperature 35.2 ° C temperature rec .... SAT 02 98% Weight 3400gr
Physical examination Emergency:
TRIANGLE EVALUATION pediatric respitoria abnormal. circulatory normal, normal.
General appearance: good performance status, active and reactive, and normohidratat
normocolorejat.
Cardiac: rhythm tones. Systolic murmur intensity multifocal III / VI. peripheral pulses
present and symmetrical.
Respiratory: good air entry bilaterally. bibasals crackles. subcostal retractions, and
supraesternal. tachypnea.
Abdominal soft depresible. not painful on palpation. hepatomegaly of 1 cm. no signs of
peritonisme. preserved peristalsis.
ENT: Otoscope normal. normal oropharynx. no exudates.
neurology: FNT. No focalitat.
Skin: no petechiae or purpura.

2. FURTHER EXPLORATION
- Nasopharyngeal aspirate: positive RSV, metapneumovirus negative.
- Chest X-ray: increased hiliar peribronquial plot. cardiomegaly base (double shunt ED)
no parenchymal s'objectiven condensations.
Clinical
with clinically suspected bronchiolitis, bronchodilator test is performed with good
response to emergencies.
is entered in the hospital with bronchodilators nebulitzats every 4 hours. RSV isolated
in nasopharyngeal smears, which is performed by respiratory and contact isolation. The
clinical evolution is favorable, maintaining proper saturation without oxygen.
can finally move on camera dated 11/4/12 and can register now with great EG and no
signs of respiratory distress.
gastroentrerologia recommended INFATRINI introduced with the same volume as we
raise KCAL to 140 Kcal / Kg / day.
as we have in the hospital, we followed Duocal supplements, starting with 3 cacitos (as
I had at home). high to be discussed with the patient again to Dr. Pociello ordering of
infatrini
DIAGNOSTICS
446.11 bronchioles TIS sincital water for respiratory virus (RSV)
745.4 / a membranous VSD
745.5 / 3 bone CIA. Cleaning
PROCEDURES
Nasopharyngeal ASPIRA. Chest X-ray. aerosol
TREATMENT AND RECOMMENDATIONS TO THE TOP
Salbutamaol inhalation on camera: 4 puff every 6 hours.
expected duration: 5 days. You must finish before consulting with your pediatrician.
frosemida. Spironolactone and captopril: follow the same treatment before you login.
ALIMENTACION: when the disponga of, You must start with ALIMENTACION
infatrini (dietary products of high caloric value). until you disponga of products will
continue to say to supplementation with duocal.
THE HIGH DESTINATION: HOME
normal venous drainage to the pulmonary veins. pulmonary veins are filled
crutch aortic left signs of obstruction
normal ventricular function. 6 aspect of myocardial hypertrophic
closed ductus