Mollah Md Abid Hossain, Nahar Jebun, Purakayostho Priya, Tabassum Nabila, Ahmed Tasnima, Khan Sherin, Jashim Sabrina, Chisti Mohammod Jobayer
BIRDEM General Hospital (Mother and Children Wing), Dhaka, Bangladesh.
Nottingham University Hospital, Nottingham, UK.
Glob Pediatr Health. 2024 Dec 6;11:2333794X241304580. doi: 10.1177/2333794X241304580. eCollection 2024.
A 7-month-old girl had been suffering from progressively deteriorating pneumonia despite getting multiple courses of broad-spectrum antibiotics as well as anti-fungal drugs for adequate duration. To find out the cause behind this deterioration, the patient underwent thorough clinical and relevant laboratory evaluation including chest radiology & imaging, screening for primary immune deficiency disorders (PID), cystic fibrosis, tuberculosis, invasive fungal pneumonia, congenital heart disease, covid pneumonia, TORCH etc. but failed to solve the mystery. Upon further detailed re-evaluation, it was discovered that the child had a history of being forcefully fed lentil-based khichuri (a rice-lentil mixed dish) during her weaning process and diagnosis was finally confirmed as hypersensitive pneumonia due to lentil aspiration by a high level of IgG, specific to lentil antigen. Treatment was commenced with prednisolone resulting in significant improvement in her clinical and radiological condition within 72 hours.
一名7个月大的女童尽管接受了多疗程的广谱抗生素以及足够疗程的抗真菌药物治疗，但肺炎仍在逐渐恶化。为了找出病情恶化的原因，对该患者进行了全面的临床和相关实验室评估，包括胸部放射学和影像学检查、原发性免疫缺陷疾病（PID）筛查、囊性纤维化、结核病、侵袭性真菌性肺炎、先天性心脏病、新冠肺炎、TORCH等，但仍未能解开谜团。经过进一步详细的重新评估，发现该儿童在断奶过程中有被强行喂食小扁豆基khichuri（一种大米和小扁豆混合菜肴）的病史，最终通过针对小扁豆抗原的高水平IgG确诊为因小扁豆误吸导致的过敏性肺炎。开始使用泼尼松龙治疗，72小时内其临床和放射学状况有显著改善。
