Left Basilar Pneumonia Simulating Perforated Appendicitis with Peritonitis in a Child

ABSTRACT

We present an 8-year-old boy who presented with predominant abdominal symptoms initially to the referring hospital and the initial Chest radiograph being reported as normal. Inflammatory markers being sky high with abdominal symptoms and minimal Chest signs, he was referred to as an atypical case of Perforated Appendicitis. By the time patient was seen in the Tertiary University Teaching Hospital, he had developed classic clinical features of Left Basilar Pneumonia which was clearly evident on good quality repeat Chest radiograph and Ultrasound confirmed it and ruled out any abdominal pathology. The patient responded well to intravenous antibiotics followed by oral one with excellent recovery. Our case is a usual reminder of the fact that a patient is more likely to have a rare presentation of a common disease, than a common presentation of a rare one. Take a careful history and examine the child; consult the appropriate specialist resources and then, if necessary, extend your history and examination with review of available investigations especially being good at reading plain radiographs.