Figure 1a Growth chart of the patient, showing steady borderline growth
on 3rd centile (assessed by program Auxo
2018©Dr.PetrLesný, Hana Krasnicanova). Figure 1b Anteroposterior chest
radiograph taken on admission demonstrating bilateral infiltrative
changes and reduced transparency of lungs, in the left middle and lower
lung field almost homogeneous reduction, with inflammatory infiltration.
1st Challenge point :
The patient had no notable past medical history and was fully vaccinated
according to the Czech national schedule (including pneumococcal
vaccine), yet experienced an uncommonly rapid progression of respiratory
insufficiency, with fever and night sweats. His chest X-ray scan showed
an alarming image of markedly reduced translucency.