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Last updated: September 17, 2025 • View editorial policy

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Differential Diagnosis for High Cough and Fever in a Baby

Single Most Likely Diagnosis

  • Viral Upper Respiratory Tract Infection (URTI): This is the most common cause of cough and fever in babies, often due to viruses such as rhinovirus, coronavirus, or respiratory syncytial virus (RSV). The symptoms typically include runny nose, cough, and sometimes fever.

Other Likely Diagnoses

  • Bronchiolitis: Common in infants, especially those under 2 years, caused by RSV and other viruses. It leads to inflammation and congestion of the small airways.
  • Pneumonia: Can be caused by bacteria, viruses, or fungi. Symptoms include cough, fever, and difficulty breathing.
  • Croup: A common childhood condition characterized by a barking cough and hoarse voice, often caused by a viral infection.
  • Influenza: Although less common in babies, influenza can cause severe illness and should be considered, especially during flu season.

Do Not Miss Diagnoses

  • Pertussis (Whooping Cough): A highly contagious bacterial infection that can be severe in infants, characterized by a distinctive whooping sound during coughing fits.
  • Bacterial Tracheitis: A rare but serious infection of the trachea that can cause severe cough, fever, and difficulty breathing.
  • Pneumococcal Disease: Includes infections such as pneumonia, meningitis, and sepsis, caused by Streptococcus pneumoniae, which can be severe in young children.
  • Severe Acute Respiratory Syndrome (SARS) or COVID-19: Although rare, these viral infections can cause severe respiratory illness and should be considered, especially during outbreaks.

Rare Diagnoses

  • Tuberculosis (TB): A bacterial infection that can cause cough, fever, and other symptoms. It's rare in infants but should be considered, especially if there's a family history or exposure.
  • Cystic Fibrosis: A genetic disorder that can cause severe respiratory and digestive problems. While not typically diagnosed with just cough and fever, it's a consideration in recurrent or severe respiratory infections.
  • Foreign Body Aspiration: Can cause sudden onset of cough and respiratory distress if an object is inhaled into the airways.
  • Congenital Heart Disease: Certain heart defects can lead to respiratory symptoms due to pulmonary congestion or other complications.

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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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