PAED-0235

PAED-0235

A 6 year old Somalian boy is admitted to the emergency department with dyspnoea. He looks distressed and has a heart rate of 180 bpm and a blood pressure of 130/90 mmHg. His respiratory rate is 37/min and his O2 saturation is 83% in room air. His temperature is 38C. His mother cannot speak English and neither does the child. The doctors observe that the boy has marked recession and a tracheal tug. He is crying and holding his chest. You immediately put the child on high flow oxygen, perform a chest X-ray and blood tests. The x-ray reveals bilateral pulmonary infiltrates. The blood results show:Hb:6g/dl, MCV:85fl, MCHC:36.0g/dl, WBC:19.6×109/l, neutrophils:15.3×109/l, PLT:350×109/l, CRP:50. His mother shows you that the child has been taking folic acid, hydroxyurea and Penicillin V daily, by pulling some tablets from her bag. What is the most probable diagnosis?