The chest radiograph showed generalized
hyperaeration with right middle lobe atelectasis (Fig. 2A).
Computerized tomography of the chest was performed
and showed complete atelectasis of the right middle
lobe and mild tubular bronchiectasis, intralobular
septal thickening was noted at the posterior basal
segment of the right lower lobe (Fig. 2B). The diagnosis
of cystic fibrosis was suspected even though it is
rare in Thailand.
The sweat chloride test was not available at
this hospital, so a modified sweat chloride test was
created to support the diagnosis. The patient was placed
under a heater to induce sweating. The skin was cleaned
and covered with sterile gauze occluded with a transparent
adhesive to prevent evaporation. The gauze was
squeezed and the sweat collected in a capillary tube
and sent for immediate laboratory analysis. The serum
and sweat electrolytes obtained at the same time are
presented in Table 1.