Allergy & Immunology

An 8-year-old 25-kg boy is scheduled for functional endoscopic sinus surgery. He has a history of hypogammaglobulinemia diagnosed at 4 months of age with recurrent sinus and respiratory tract infections, and was seen in the emergency department 2 weeks ago requiring an epinephrine injection for moderate respiratory distress. He has a productive cough constantly, and bronchiectasis by X-ray. His medications include cromolyn, terbutaline, sulfamethoxazole/trimethoprim, and an inhaler. Vital signs are BP 90/60 mmHg, P 100 bpm, R 18/min, T 37°C and his Hb is 13 g/dL.