Mycoplasma pneumonia with congenital heart disease of a 4 month old baby boy

A 4 month 13 days old male child had been presented in the Emergency of Ruby General Hospital with complaints of fever and respiratory distress for last four days associated with cough and cold. He was taken to a local hospital for treatment but his condition deteriorated further and was brought to Ruby Emergency where he was immediately put under the expert care of Dr. Parichaya Bera (Consultant Paediatric). A thorough evaluation revealed mycoplasma pneumonia and detection of heart murmur during a routine check up done two weeks ago indicated the possibility of Congenital Heart Disease (CHD). The paediatric team immediately sprung into action and the baby had been managed with moist O2 inhalation, IV fluids and was shifted to PICU. He developed severe respiratory distress with chest retractions despite of being on Humidified High Flow Nasal Cannula (HHFNC), so, the baby was intubated and put on mechanical ventilation. The echocardiogram revealed Single Ventricle, Transposition of the Great Arteries (TGA) (A heart defect that occurs when the two main blood vessels leaving the heart are in abnormal positions) with moderate pulmonary stenosis (Narrow pulmonary valve making it difficult for blood to flow from the heart to the lungs). Central line had been done in the right Internal Jugular Vein (IJV). Paediatric cardiology opinion had been taken as the echocardiogram showed conoventricular ventricular septal defect (VSD) (A hole just before the pulmonary valve in the right ventricle and just before the aortic valve in the left ventricle, connecting the two chambers). Gradually the baby improved and was weaned off ventilation support and extubated followed by Orogastric (OGT) feeding (A method of providing nutrition to a baby or infant by placing a soft, flexible tube through the mouth and into the stomach) and eventually breastfeeding was started. In a weeks time the baby had improved clinically and was fit to go back home. The parents thanked Ruby paediatric team for their relentless effort and strengthening their faith.