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An 18-month-old boy is brought to the emergency department for evaluation of a productive cough and fever. He has had 8 office and emergency department visits over the past year, all of which required antibiotics for diagnoses of sinusitis and pneumonia. He was delivered vaginally without complications. His older brother has had similar recurrent infections throughout his life. Temperature is 38.9 C (102 F) , blood pressure is 90/60 mm Hg, pulse is 120/min, and respirations are 30/min. The patient's pulse oximetry is 99% on room air. Examination of the oropharynx reveals mildly enlarged tonsils without erythema or exudate. Auscultation reveals rales and rhonchi in both lungs, and point of maximal impulse is displaced to the right side of the chest. What is the most likely diagnosis?
Corporate Governance
The system of rules, practices, and processes by which a company is directed and controlled, balancing the interests of stakeholders.
Secondary Data
Information that has been collected previously by someone else for a purpose other than the current research project, such as census data, sales reports, and historical records.
Electronic Format
A format in which data is stored, presented, or exchanged using digital technology, such as ebooks, PDFs, or online documents.
Nonstore Retailing
The selling of goods and services outside traditional brick-and-mortar locations, including online, by mail, or via direct sales.
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