A 2-Month-Old Boy With Respiratory Distress, Thrombocytopenia, and an Aggressive Mediastinal Mass

A 2-month-old male infant with symptoms of dyspnea and progressive thrombocytopenia was referred to our tertiary care center. Physical examination at the referring hospital revealed tachypnea, head-nodding respiration, and poor appetite. Laboratory tests revealed severe thrombocytopenia (platelet count, 11 × 10⁹/L), anemia (hemoglobin, 73 g/L), and coagulopathy (thrombin time, 33.9 s; fibrinogen: 0.25 g/L; D-dimer: 55.13 mg/L). Echocardiography revealed pericardial effusion and decreased ventricular function. He was initially diagnosed at the referring hospital with "severe pneumonia and thrombocytopenia" and received empirical treatment with antibiotics and platelet and red cell transfusions but showed limited clinical improvement.