Which body system was primarily involved in this illness? Would you expect this illness to be infectious, allergic, or toxic in origin? Why was this patient discharged to his grandmother’s house rather than his own home? How would you go about establishing the cause of the illness?
A two-month-old boy was brought to the hospital because he vomited a large quantity of dark red material. Previously well, a few days earlier he had abruptly interrupted a crying episode and then appeared to have difficulty breathing. There were no recognized illnesses and no history of trauma or abuse. He was bottle-fed. Both parents smoked in the home, which was located in an area of the city characterized by substandard housing in poor repair. Three weeks before admission, their house became flooded during a storm. Cleanup had not yet been accomplished. On examination, the baby was well developed and nourished, and there was no evidence of trauma or infection. His breathing was labored. His white blood count was within normal limits, but he was moderately anemic. His blood clotted normally, but his blood oxygen was low. His chest X-ray showed patchy shadows consistent with fluid in the alveoli. The patient was initially placed on a respirator and treated in the intensive care unit for five days. In two weeks, he appeared to be normal and was discharged to his grandmother’s house. Over the next few days, infants with similar illnesses were admitted to the hospital. All came from the same area of the city as the first patient. Some of them died. Some were sent home well but were later readmitted because of recurrent symptoms.
- Which body system was primarily involved in this illness?
- Would you expect this illness to be infectious, allergic, or toxic in origin?
- Why was this patient discharged to his grandmother’s house rather than his own home?
- How would you go about establishing the cause of the illness?
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