MULTIDISCIPLINARY APPROACH TO A COMPLEX CASE OF ACUTE CHILD PNEUMONIA.

We present a non-vaccinated 2 years and 3 months old female patient with anti-convulsive therapy for Bourneville tuberous sclerosis (TSC) who was hospitalized for fever, polypnea, paroxysmal coughing episodes and post-tussive vomiting, respiratory failure and convulsive status. Basic paraclinical investigations revealed bilateral paramediohilar interstitio-alveolar infiltration, normal liver and renal parameters, elevated CRP and procalcitonin, but the presence of very high white blood cell count with lymphocytosis raised suspicion of leukemia. It was excluded by bone marrow aspirate examination and the diagnosis of convulsive cough was confirmed based on the clinical and laboratory parameters. Molecular genetic test confirmed the diagnosis of tuberous sclerosis type 2. Taking in account that the child had partially controlled seizures and cerebral, cardiac and renal characteristic lesions, this case raised a lot of questions regarding the infectious contact and the possibility of other potentially severe infectious diseases prevention by vaccination. A hope in this case is the new approved in children drug everolimus. In conclusion, pneumonia, a common disease in pediatric age, can raise many diagnostic and therapeutic problems mainly in patients with chronic pathology, requiring multidisciplinary collaboration for successful management of the case. [ABSTRACT FROM AUTHOR]