Nonaccidental trauma presenting with respiratory distress and pleural effusion.
Nonaccidental trauma (NAT) is common and presents with varied symptoms. Pleural effusion as a complication of physical abuse has not been described in the past. We report the case of a 10-week-old infant who presented with multiple nonspecific complaints that included respiratory distress, refusal to feed, constipation, and lethargy. Sepsis was the working diagnosis on admission, but a massive pleural effusion and rib fractures seen on chest imaging ultimately led to the diagnosis of nonaccidental trauma. This interesting case highlights the importance of maintaining a high index of suspicion for abuse irrespective of atypical presenting signs.
Department of Pediatrics, Crozer-Chester Medical Center, Upland, PA 19013, USA.
Malvika
M
Sagar
Samarth
S
Shukla
Kelly
K
Bradley-Dodds
D001906:Botulism / Q000175:diagnosis; D002649:Child Abuse / Q000175:diagnosis*; D003248:Constipation / Q000150:complications; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005264:Femoral Fractures / Q000209:etiology; D005360:Fibula / Q000293:injuries; D050723:Fractures, Bone / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis; D010281:Parathyroid Hormone / Q000097:blood; D010996:Pleural Effusion / Q000209:etiology*; D018410:Pneumonia, Bacterial / Q000175:diagnosis; D011885:Radius Fractures / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology*; D012272:Ribs / Q000293:injuries*; D018805:Sepsis / Q000175:diagnosis; D013898:Thoracic Injuries / Q000209:etiology*
D010281:Parathyroid Hormone