Differential Diagnosis for Coughing, Sneezing, and Red Eye in a 4-Month-Old
Single Most Likely Diagnosis
- Viral upper respiratory tract infection (URTI): This is the most common cause of coughing, sneezing, and red eyes in infants, often due to viruses such as rhinovirus, coronavirus, or adenovirus. The symptoms presented are typical for a self-limiting viral infection.
Other Likely Diagnoses
- Allergic rhinitis: Although less common in infants, allergic reactions to environmental allergens can cause similar symptoms. Family history of allergies and exposure to potential allergens would support this diagnosis.
- Viral conjunctivitis: Viral infections can cause conjunctivitis, leading to red, watery eyes, and can be accompanied by upper respiratory symptoms.
- Bronchiolitis: Caused by respiratory syncytial virus (RSV) and other viruses, bronchiolitis can present with cough, sneezing, and sometimes eye symptoms, especially in young infants.
Do Not Miss Diagnoses
- Bacterial conjunctivitis: Although less common than viral conjunctivitis, bacterial conjunctivitis requires prompt antibiotic treatment to prevent serious complications, such as vision loss.
- Pneumonia: Bacterial pneumonia can present with cough and respiratory distress. While less likely with the additional symptom of red eye, it's crucial to consider due to its potential severity.
- Whooping cough (Pertussis): A highly contagious bacterial infection that can cause severe coughing fits, sometimes accompanied by sneezing and eye symptoms. Vaccination status and exposure history are important considerations.
Rare Diagnoses
- Kawasaki disease: A rare condition that can cause conjunctivitis, among other symptoms like fever and rash. It's essential to consider due to its potential for cardiac complications if untreated.
- Foreign body in the eye or airway: Although rare, the presence of a foreign body can cause sudden onset of symptoms, including coughing, sneezing, and red eye, and requires immediate medical attention.
- Immunodeficiency: Underlying immunodeficiency conditions can predispose infants to more severe or unusual infections, presenting with a combination of respiratory and ocular symptoms.