A 1 year and 8 months old boy, with mild motor developmental delay and right hemiparesis following a perinatal brain injury, was brought with a history of fast breathing and cough for 2 months and low-grade fever of 10 days duration. He was second born to non-consanguineously wed parents by spontaneous vaginal delivery with delayed cry at birth and neonatal intensive care unit stay for 10 days. There was no exposure to cigarette smoke. On examination there was mild central cyanosis with pan digital clubbing; pulse rate was 102 per minute; respiratory rate was 44 per minute; oxygen saturation of 89% which improved to 95% with 2 L/min of oxygen. On systemic examination, cardiovascular status was found to be normal; respiratory examination revealed coarse crepitations bilaterally in the entire lung …