High Altitude Pulmonary Edema in a Healthy Pediatric Patient Traveling from Denver to Breckenridge

A healthy 11-year-old boy presented with headache, nausea, and cough to a clinic at 2926 meters of altitude one day after ascending from his home altitude of 1578 meters. The patient had made multiple trips to the same altitude without any symptoms or sequelae throughout his childhood. Physical examination was significant for rales, tachycardia, and pulse oximetry level of 86% on room air. Radiographic evaluation with plain films revealed patchy alveolar opacities throughout the right lung. He received treatment with dexamethasone and high-flow face mask supplemental oxygen. In less than two hours, his rales had resolved, and his oxygen saturation had dramatically improved. He was discharged back to his native altitude and was at his baseline later the same day. High altitude pulmonary edema is a rare occurrence in children, but it is exceedingly rare for a healthy child with no history of pulmonary hypertension ascending only 1348 meters.