Question

a 6 - year boy presents with a chronic productive cough with copious amounts of foul - smelling purulent sputum. chest x - ray demonstrates a large infiltrate involving the right lower lung field. which of the following is the most likely diagnosis of this patient?
bronchiolitis
bronchiectasis
idiopathic pulmonary fibrosis
hypersensitivity pneumonitis

Explanation:

• Bronchiolitis: Usually affects infants, presents with wheezing, not chronic purulent sputum.
• Bronchiectasis: Characterized by chronic productive cough with foul - smelling, copious purulent sputum, and lung infiltrates can be seen.
• Idiopathic Pulmonary Fibrosis: Presents with progressive dyspnea and interstitial lung changes, not purulent sputum.
• Hypersensitivity Pneumonitis: Caused by inhaled antigens, presents with cough, fever, and interstitial changes, not chronic purulent sputum.

Answer:

B. Bronchiectasis