Respiratory viruses (influenza, RSV, parainfluenza)Downloads

A 6-month-old infant is brought to the physician’s office by his parents due to a fever, cough, and shortness of breath. The cough is dry and has been progressively worsening for the past 48 hours along with the shortness of breath. His fever never exceeded 37.8°C (100.0°F) at home. The parents say that he has also had abundant nasal drainage and loss of appetite. He is irritable and vomited twice during this period. He has no relevant medical or family history. His vitals are the following: Pulse rate 165/min Respiratory rate 77/min Temperature 38.0°C (100.4°F) On physical examination, there is nasal congestion with thick secretions, accompanied by nasal flaring. On chest examination, intercostal retractions are seen and diffuse wheezing on both sides are heard on auscultation. What is the most likely cause?

A 2-year-old boy is brought to the physician by his parents for the evaluation of an unusual cough, a raspy voice, and noisy breathing for the last 2 days. During this time, the symptoms have always occurred in the late evening. The parents also report that prior to the onset of these symptoms, their son had a low-grade fever and a runny nose for 2 days. He attends daycare. His immunizations are up-to-date. His temperature is 37.8°C (100°F) and respirations are 33/min. Physical examination shows supraclavicular retractions. There is a high-pitched breath sound on inspiration. Which of the following is the most likely location of the abnormality?