The patient, a 6-month-old female, was the 2,183-g (25th centile) product of an uncomplicated 36-week pregnancy of a 21-year-old, gravida 2, para 2, white female. Labor and delivery were uneventful. The infant remained in the hospital for 8 days because of thermolability and hyperbilirubinemia of unknown origin to 16 mg/dl. The jaundice resolved rapidly with phototherapy. During the second week of life she developed chronic cough with coryza. She was noted to spit up after some feedings. Despite these problems, her growth remained between the 10th and 25th centile for age and sex. There had been no history of pneumonia, cyanosis, poor feeding, pallor, diaphoresis, weakness, hypotonia, or irritability.Seven days before admission she developed green, watery stools. Three days later her stools became normal, but she was noted to have green rhinorrhea with productive cough. On the day before admission, her physician gave her second DPT and OPV immunizations, oral erythromycin, and a cough syrup for "bronchitis." On the morning of admission she became increasingly irritable and had difficulty breathing.Address reprint requests to