Case 31-1978

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Abstract
Presentation of CaseA 14-year-old boy was admitted to the hospital because of dyspnea.He was well until four months earlier, when he began to experience fatigue and exertional dyspnea. He gradually gave up sports. A hacking, nonproductive cough appeared, with a low-grade fever that subsided promptly. Three days before admission fever recurred, with increased cough and severe dyspnea.The boy was born in the Dominican Republic. In early infancy a draining sinus was observed in the right side of the neck, but it soon healed. He was brought to this country at the age of 10 years. Physical examination, . . .