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.