Differential Diagnosis for a 4-year-old with Fever, Laboured Breathing, and Coughing
- Single Most Likely Diagnosis
- Viral pneumonia: The high fever, laboured breathing, coughing, and the fact that the child is still able to void and snack occasionally suggest a respiratory infection. Viral pneumonia is common in children and can cause these symptoms.
- Other Likely Diagnoses
- Bacterial pneumonia: Similar to viral pneumonia but caused by bacteria. The symptoms can be very similar, and distinguishing between the two often requires further testing.
- Influenza: Given the high fever and respiratory symptoms, influenza is a possibility, especially during flu season.
- Bronchiolitis: Common in young children, especially those under 2, but can occur in older children as well. It's characterized by inflammation of the bronchioles, often due to a viral infection.
- Do Not Miss Diagnoses
- Pneumococcal sepsis: Although less likely, this condition is life-threatening and requires immediate attention. The high fever and laboured breathing could be indicative of a severe infection.
- Epiglottitis: A rare but potentially life-threatening condition that causes inflammation of the epiglottis, which can lead to airway obstruction. The laboured breathing and high fever are red flags.
- Meningitis: Although the primary symptoms are respiratory, meningitis can present with fever and altered mental status. The decreased appetite and occasional snacking could be non-specific signs of illness.
- Rare Diagnoses
- Tuberculosis (TB): Uncommon in young children in many parts of the world but should be considered, especially if there's a history of exposure or travel to areas where TB is prevalent.
- Cystic Fibrosis exacerbation: If the child has a known history of cystic fibrosis, an exacerbation could present with these symptoms.
- Foreign body aspiration: Although more typically presents with sudden onset of symptoms, it's a possibility if the child has had access to small objects that could be aspirated.