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Last updated: August 23, 2025View editorial policy

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Differential Diagnosis for Cough and Fever in an Infant

Single Most Likely Diagnosis

  • Viral upper respiratory tract infection (URTI): This is the most common cause of cough and fever in infants, often due to viruses such as rhinovirus, coronavirus, or respiratory syncytial virus (RSV). The symptoms are usually self-limiting and include runny nose, cough, and sometimes fever.

Other Likely Diagnoses

  • Bronchiolitis: Common in infants, especially those under 2 years old, caused by RSV and other viruses. It presents with cough, wheezing, and sometimes fever.
  • Pneumonia: Can be caused by bacteria (like Streptococcus pneumoniae) or viruses. Symptoms include cough, fever, and difficulty breathing.
  • Influenza: Especially during flu season, influenza can cause cough, fever, and other respiratory symptoms in infants.
  • Croup: Characterized by a barking cough and hoarseness, often due to a viral infection.

Do Not Miss Diagnoses

  • Pertussis (Whooping Cough): A highly contagious bacterial infection that can cause severe coughing fits, especially in infants who are not fully vaccinated. It's crucial to diagnose and treat promptly to prevent complications.
  • Bacterial pneumonia: While less common than viral causes, bacterial pneumonia can be severe and requires antibiotic treatment.
  • Congenital heart disease: Though not an infection, undiagnosed congenital heart disease can present with respiratory symptoms due to heart failure.
  • Foreign body aspiration: Can cause sudden onset of cough and respiratory distress, and is a medical emergency.

Rare Diagnoses

  • Tuberculosis (TB): Though rare in infants in many parts of the world, TB can cause chronic cough, fever, and other systemic symptoms.
  • Cystic fibrosis: A genetic disorder that can cause recurrent respiratory infections, among other symptoms.
  • Immunodeficiency: Conditions that impair the immune system can lead to recurrent or severe infections, including those causing cough and fever.
  • Anatomical abnormalities: Such as tracheoesophageal fistula or laryngomalacia, which can cause respiratory symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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