Format

Send to

Choose Destination
Medicine (Baltimore). 2018 Jun;97(24):e10580. doi: 10.1097/MD.0000000000010580.

Acute scoliosis as an unusual presentation of pneumonia: A case report.

Author information

1
Department of Paediatric Emergency, Chelsea and Westminster Hospital, Chelsea, London.

Abstract

We describe the unique case of a child with pneumonia presenting with acute scoliosis and abdominal pain, without any typical features of the disease.A 10-year-old girl presented to the emergency department on 3 consecutive days with right-sided abdominal pain. There were no associated features, in particular, no fevers or respiratory symptoms. On the first 2 presentations, observation,examination, and blood test findings were unremarkable. Chest x-ray and abdominal ultrasound were also normal. On the third presentation a marked scoliosis was noted and abdominal examination revealed right-sided tenderness with rebound. The patient was admitted and a computed tomographic scan of the abdomen arranged. Unexpectedly, this revealed a right lower lobe pneumonia and associated pleural effusion. Despite treatment, the parapneumonic effusion enlarged rapidly and she developed respiratory distress, necessitating transfer to a tertiary centre.The diagnosis of pneumonia can be challenging because of a lack of respiratory signs, the masking of systemic features by antipyretic effects of first-line analgesics, and a high rate of false-negative chest radiographs. The development of acute scoliosis should lead the clinician to strongly consider pneumonia in such circumstances.

PMID:
29901573
PMCID:
PMC6024161
DOI:
10.1097/MD.0000000000010580
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wolters Kluwer Icon for PubMed Central
Loading ...
Support Center