Differential Diagnosis for Inability to Inspire after Coughing Spells with Persistent Tachycardia and Positive Rhinovirus Test

• Single Most Likely Diagnosis
  • Acute bronchiolitis or viral pneumonia: The patient's symptoms of inability to inspire after coughing spells, persistent tachycardia, and a positive test for rhinovirus suggest a lower respiratory tract infection, which is consistent with acute bronchiolitis or viral pneumonia, especially in the context of a viral infection.
• Other Likely Diagnoses
  • Asthma exacerbation: The coughing spells and difficulty inspiring could be indicative of an asthma exacerbation, particularly if the patient has a history of asthma. The rhinovirus infection could be a trigger for the exacerbation.
  • Pneumonia (bacterial): Although the patient tested positive for rhinovirus, it's possible that the pneumonia could be bacterial in nature, either as a primary infection or as a secondary complication of the viral infection.
• Do Not Miss Diagnoses
  • Epiglottitis: This is a life-threatening condition that requires immediate attention. Although less common, epiglottitis could present with severe respiratory distress, including an inability to inspire, and tachycardia.
  • Foreign body aspiration: This is another emergency condition that could cause sudden onset of respiratory symptoms, including coughing and difficulty breathing.
  • Pneumothorax: A spontaneous pneumothorax could occur, especially if the patient has underlying lung disease, and would require immediate medical intervention.
• Rare Diagnoses
  • Cystic fibrosis exacerbation: If the patient has cystic fibrosis, a rhinovirus infection could trigger an exacerbation, leading to increased respiratory symptoms.
  • Interstitial lung disease: Certain types of interstitial lung disease could be exacerbated by a viral infection, leading to worsening respiratory symptoms.