CASE PRESENTATIONALCOVER, LLEWELL T.DAVID, KYNA B.DEUNIDA, RONECAR V.OBIDA, ARIANNE A.TARROJA, CYRILLE AGNESIntroductionYour!nd"nc!dE#S$ro"id!r c%%!d to t&! &o'! o( )*+!r*o%d ,it& -r!t&in.di/cu%t+.0!r'ot&!r1+1 t&!c&i%d&1&dco%d(ort&!%1t t,od+1,it&incr!1in.cou.&in.. S&!i1no,&"in.trou-%!ctc&in. &!r -r!t&.G!n!r% A11!11'!ntYou1!!t&inc&i%d,&oi11ittin.u$ri.&t ndu1in.&!rcc!11or+'u1c%!.S&! $$!r1,orri!dnd%!rt%+,tc&!1+ou $$roc& &!r.S&!i1,or2in.&rdto-r!t&!,it& incr!1!din1$irtor+nd!3$irtor+ !4ort.S&!$$!r1to-!(orcin.t&!ir outdurin.!3&%tion,,&ic&$$!r1 $ro%on.!d.0!rco%or$$!r11o'!,&t $%!.5u!1tionW&t i1 +our initi% i'$r!11ion o( t&! c&i%d61 condition -1!d on +our .!n!r% 11!11'!nt7Do!1 t&! c&i%d n!!d i''!dit! int!r"!ntion7 I( 1o, ,&t int!r"!ntion i1 indict!d7An1,!rT&! initi% $$!rnc! i1 1!riou1 -!cu1! o( t&!c&i%d61n3i!t+nd%-or!d-r!t&in. ,it& $ro%on.!d, (orc!d !3$irtor+ !4ort. 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SA#PLE 'n!'onicW&t 1$!ci8c &i1tor+ 9u!1tion1 r! +ou int!r!1t!d in 2no,in. -out t&i1 c&i%d7An1,!r Si.n1 nd 1+'$to'1A%%!r.i!1M!diction1P1t '!dic% &i1tor+L1t '!%E"!nt1 %!din. to $r!1!nttionAn1,!r Signsandsymptoms-!.nt,od+1.o,it&co%dt&t $ro.r!11!dto'or!cou.&in.tod+.Atti'!1t&!c&i%d61 cou.&in.r!1u%t!din!'!1i1,nd1&!&1not-!!n-%!to '2! 'uc& or%%+.S&! &1&i1tor+ o( %%!r.ic r&initi1 -ut no ot&!r allergies.T&!on%+medications&!r'ot&!r."!,1cou.&1+ru$, ,&ic& &1 not &!%$!d.0!r past medical history i1 not-%! (or&i1tor+ o( cou.&in. ,it& $r!"iou1 co%d1, -ut 1&! &1 n!"!r -!!n t&i1 i%% -!(or!. S&! %1ocou.&1(r!9u!nt%+tni.&tnd&1co'$%in!do( ti.&tn!11 in &!r c&!1t nd cou.&in. 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In o%d!r c&i%dr!nFHD+!r1G'+co$%1'i1t&!'o1t co''oncu1!o(,&!!:in.*11ocit!d%o,!r r!1$irtor+trctin(!ction.In&%tioninIur+ ndn$&+%3i1'+%1ocu1! -ronc&o1$1', %!din. to ,&!!:in. nd 1i.n1 o( %o,!r ir,+ o-1truction.Su''r+In1u''r+,t&i1c&i%d&dcut!,1!"!r!1t&' r!9uirin.ur.!ntt&!r$+.S&!,1t1i.ni8cntri12 d!t!riortion in "i!, o( t&! c%inic% !"id!nc! (or 1!"!r! %o,!rir,+o-1truction'ni(!1t!d-+&!rin-i%it+to 1$!2 'or! t&n on! ,ord tti'! nd t&! 1i.ni8cnt $u%1u1$rodo3u1d!t!ct!d-+1i'$%!$%$tiono(&!r $u%1!.I(r!1$irtor+(i%ur!d!"!%o$1,r!'!'-!rt&t !4!cti"!-.*'12"!nti%tion$$roc&J;r!1cu!r $!r(or'1&!d ti%t*c&in %i(t nd 1!%1 t&!'12 to t&! (c!,&i%!t&!>ndr!1cu!rco'$r!11!1t&!"!nti%tion -.. A"oid r$id "!nti%tion rt!1 1inc! ir tr$$in. nd (urt&!ri'$ir'!nto(crdicout$ut,i%%occur,it& o"!r"!nti%tion.Su''r+T&!tr!t'!nto(%o,!rir,+o-1truction(ro' 1t&'t+$ic%%+con1i1t1o(-ronc&odi%tor t&!r$+Fn!-u%i:!d%-ut!ro%ndi$rtro$iu' -ro'id!ndIV'.n!1iu'in1!"!r!c1!1G %on.,it&1+1t!'iccortico1t!roidt&!r$+. 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