1. Recurrent Cough, Sputum Lin Hongzhou

2. Chief Complaint A 11-year-old boy was admitted to the hospital for recurrent cough, sputum for 10 years.

3. History In the past 10 years, he had recurrent cough, shortness of breath, with a white mucoid sputum, and fatigue. During the first few years of life he had persistent mucopurulent rhinitis, intermittent wet cough, and bilateral serous otitis media.

4. History He is the single child in his family. His parents are healthy, and non- consanguineous marriage. No other patient like this in his clan.

5. Physical Examination His vital signs were as follows: body temperature, 37.8 ℃ ; blood pressure, 90/60 mm Hg; heart rate, 92 beats/min; and respiratory rate, 12 breaths/min. The oxygen saturation was 95% while he was breathing ambient air.

6. Physical Examination Marasmus, growth retardation. No enlargement of Superficial lymph node. Slightly cyanotic lips, congestion of throat. Pulmonary examination revealed mild barrel chest and rhonchus. Apex beat in the right intercostal space. The rest of the physical examination results were normal.

7. Chest-X-Ray

8. Question 1 What is the likely diagnosis? 2 What’s the complications of this disease? 3 What screening and diagnostic tests are available? 4 How to treat this patient?