The fever broke. The crackles in the lungs disappeared. The cough stopped. By every measure that mattered for pneumonia, the 5-month-old boy in Borama, Somalia, was improving. His oxygen saturation remained at 88 percent on room air and fell to 78-82 percent when he cried.
That number changed the case. Doctors ordered an echocardiogram on the fifth hospital day, and it showed tetralogy of Fallot, the most common cyanotic congenital heart defect, undetected in his first five months. Their report appears in the International Medical Case Reports Journal.
