1 Department of Pediatrics, New York Hospital-Cornell Medical Center
Dr. Moore (Resident): E.P., a male born of Greek parentage, was 6 weeks of age at the time of his first admission to the New York Hospital. He had been well until 8 days prior to admission when he began to sneeze frequently, and his eyes began to water and his cry became hoarse. On the following day the family physician made a diagnosis of croup and prescribed tetracycline, 50 mg every 6 hours, nose drops, cough syrup and syrup of ipecac. Six days before admission an intermittent cough was noted. The patient's condition remained essentially unchanged until 2 days prior to admission when he became febrile, anorectic and developed a paroxysmal type of cough which occasionally terminated in vomiting. At this time penicillin, intramuscularly, was added to the regimen. He was admitted to the New York Hospital with the diagnosis of pneumonia.
The past history, family history and review of systems were noncontributory.
Physical examination revealed a well-nourished, white male with no evidence of respiratory distress. Rectal temperature was 39.3°C, apical pulse rate was 150/min, respirations were 30/min. There was no retraction on cyanosis. Examination of the ears was normal. There was a grayish-white, plaque-like, exudative lesion over the left lateral aspect of the soft palate. The pharynx was injected. Shotty lymphadenopathy was present in the cervical chains bilaterally. There was a sinus tachycardia with no cardiac murmurs audible. The lungs were clear to percussion and auscultation. The liver was palpable 1 to 2 cm below the costal margin. The spleen and kidneys were not palpable. The remainder of the examination was not remarkable.