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Primary ciliary dyskinesia — RACP Paediatrics MCQ

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HardRespiratoryPrimary ciliary dyskinesiaRACP Paediatrics

A 3-year-old has chronic wet cough since infancy, recurrent otitis media and neonatal respiratory distress despite term birth. Examination shows dextrocardia and coarse crackles. What is the most likely diagnosis?

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Correct answer: A — Primary ciliary dyskinesia

Chronic wet cough from infancy, recurrent otitis media, neonatal respiratory distress and situs abnormality point to primary ciliary dyskinesia. Selective IgA deficiency can cause infections but does not explain dextrocardia and neonatal distress. The teaching point is that a chronic wet cough in children is pathological and warrants assessment for suppurative lung disease causes.

Reference: RCH Clinical Practice Guidelines: Chronic cough; Therapeutic Guidelines (eTG)