What is the diagnosis for a child with a non-productive cough, audible bronchial secretions, cough-induced vomiting, intermittent fever (approximately 102 degrees Fahrenheit) responsive to Tylenol (acetaminophen), and no sinus congestion, who attends daycare?

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Last updated: May 3, 2025 • View editorial policy

Differential Diagnosis for Lenora's Condition

  • Single most likely diagnosis + Viral bronchiolitis or viral pneumonia: This is the most likely diagnosis given Lenora's symptoms of non-productive cough, fever, and the presence of mucus in her chest, which are common in viral respiratory infections, especially in a daycare setting where such infections are easily spread.
  • Other Likely diagnoses + Acute bronchitis: This could be a consideration given the cough and presence of mucus, although the absence of sinus congestion and the fact that the cough is non-productive might lean more towards a lower respiratory tract infection. + Influenza: Although not specified if it's flu season, influenza can present with similar symptoms, including fever, cough, and sometimes vomiting, especially if the cough is severe.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Bacterial pneumonia: While less likely than viral causes given the context, bacterial pneumonia is a critical diagnosis to consider due to its potential severity and need for antibiotic treatment. Symptoms can be similar to viral pneumonia, and missing this diagnosis could have serious consequences. + Pertussis (Whooping Cough): Especially if Lenora is not up to date on her vaccinations, pertussis could be a consideration, particularly if the cough is severe and vomiting is a prominent symptom. It's a significant diagnosis to rule out due to its contagiousness and potential for severe complications.
  • Rare diagnoses + Foreign body aspiration: Although rare and typically presenting with a more abrupt onset of symptoms, it's a diagnosis that cannot be missed, especially if there's a history of choking or if symptoms worsen unexpectedly. + Cystic fibrosis: This is a rare genetic disorder that can present with recurrent respiratory infections and could be considered if Lenora has a history of similar illnesses or if her symptoms do not resolve as expected with treatment. However, it would be an unusual initial presentation without other signs or a family history.

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