This case presentation from a clinical pathology conference discussed diagnoses, and clinical aspects, pathological findings and diagnoses for a newborn with tachypnea, intercostal retracticus, and poor oxygen saturation.

Minocycline, a semisynthetic tetracycline, is often used to treat acne and rheumatoid arthritis. It has been considered an unlikely drug to be associated with systemic lupus erythematosus; however, many cases of drug-induced lupus related to minocycline have been reported. Some of those reports included pulmonary lupus, but none of the patients described developed respiratory distress. We describe a patient treated with minocycline for 2 years who presented with progressive dyspnea, severe hypoxia, and pulmonary infiltrates necessitating hospitalization and oxygen supplementation.

This report describes a precocious eight-year-old child who presented with hallucinations from excessive use of albuterol inhalers. Shifting the child to a powdered form of albuterol (without the fluorocarbon propellant) controlled his asthma, and his behavior improved rapidly. The potential harmful effects of fluorocarbons used as propellants for inhalers are discussed.

Partial esophageal obstruction was an unusual complication of tracheostomy in an infant. Emesis and failure to thrive prompted a modified barium-swallow study, which revealed that the tracheostomy tube was causing an obstruction in the proximal esophagus. Use of a shorter, customized tube eliminated the esophageal obstruction, allowing normal feeding and weight gain.