CASE 14
A 5-month-old girl was brought to the pediatric clinic of a local general hospital in February with a 2-day history of cough, respiratory difficulty with nasal discharge, and low-grade fever. She had begun attending a day care center 4 weeks before. All of her immunizations were up to date, and no one else at home was ill.
LABORATORY STUDIES
Diagnostic Work-Up
Table 14-1 lists the likely causes of illness (differential diagnosis). Investigational approach for delineating the etiology may include:
TABLE 14-1 Differential Diagnosis and Rationale for Inclusion (consideration)
Rationale: All the above viruses may cause indistinguishable illnesses in very young patients. Bronchiolitis should be considered based on the age and presentation. In certain times of the year, RSV, among the viral pathogens that cause respiratory illness, is simply the most common etiology, especially among infants less than 6 months old. M. pneumoniae only infrequently causes symptomatic respiratory illness in patients this young.
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