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Case 55 : คำถามประจำเดือน สิงหาคม 2561 ข้อ 2
"A 4 year old boy presented with fever and dyspnea for 5 days, he had no cough or rhinorrhea.
Physical examinations revealed BT 38.2 C, HR 136/min, RR 40/min, SpO2 96% Lungs- bronchial breath sound with dullness on percussion of RUL, no wheezing or crepitations. Others- unremarkable Chest X ray as shown in figure 1.
Intravenous cefotaxime with supportive treatment were given, his vital signs in the first 5 days of admission were in the figure 2.
Q:
1. What is the most likely diagnosis?
2. What is the most likely pathogen?
Ans:
1. Pneumonia หรือ bacterial pneumonia หรือ lobar pneumonia หรือ right upper lobe pneumonia
2. Steptococcus pneumoniae