A Case Report of Bronchopneumonia in Down Syndrome Children with Severe Wasting

Rais Amaral Haq, Luthfi Shiba Andana, Sinta Nurmalasari, Fathian Nur Dalilah, Shinta Nareswari

Abstract

Bronchopneumonia remains one of the leading causes of morbidity and mortality among children worldwide. Children with Down syndrome are at a higher risk of developing respiratory tract infections due to immune dysfunction, muscle hypotonia, and various associated anatomical abnormalities. This risk may be further increased by malnutrition and incomplete immunization status. Case: We report a case of a 4-year-old boy with Down syndrome who presented with a productive cough, intermittent fever for two months, shortness of breath, rhinorrhea, and generalized weakness. Physical examination revealed characteristic phenotypic features of Down syndrome, chest wall retractions, bilateral crackles on lung auscultation, and abdominal distension. Laboratory findings showed mild normocytic normochromic anemia and mild hypoalbuminemia. Chest radiography demonstrated right suprahilar, bilateral perihilar and paracardiac infiltrates, consolidation in the right middle lung field, bilateral lower lung emphysema, and bilateral perihilar lymphadenopathy, supporting the diagnosis of bronchopneumonia. The patient was treated with ampicillin-sulbactam, gentamicin, nebulization therapy, micronutrient supplementation, and nutritional rehabilitation, resulting in clinical improvement during hospitalization. Conclusion: Bronchopneumonia in children with Down syndrome may be aggravated by malnutrition and incomplete immunization. Early diagnosis and comprehensive management are essential to achieve favorable clinical outcomes.