Differential Diagnosis for Coughing and Wheezing in a 22-Month-Old
Single Most Likely Diagnosis
- Viral Bronchiolitis: This is the most common cause of coughing and wheezing in infants and young children, typically caused by Respiratory Syncytial Virus (RSV). The age of the child and the presentation of coughing and wheezing are consistent with this diagnosis.
Other Likely Diagnoses
- Asthma: Although less common in children as young as 22 months, asthma can present with coughing and wheezing, especially if there's a family history or if the child has had previous episodes of similar symptoms.
- Reactive Airway Disease: Similar to asthma, this condition involves airway hyperreactivity and can cause coughing and wheezing in response to various triggers.
- Pneumonia: Bacterial or viral pneumonia can cause coughing and wheezing, along with other symptoms like fever and difficulty breathing.
Do Not Miss Diagnoses
- Foreign Body Aspiration: This is a medical emergency that can cause sudden onset of coughing and wheezing. It's crucial to consider this diagnosis, especially if the symptoms started abruptly.
- Congenital Heart Disease: Certain congenital heart defects can lead to respiratory symptoms, including coughing and wheezing, due to pulmonary congestion.
- Pneumothorax: Air in the pleural space can cause respiratory distress, including coughing and wheezing, and is a condition that requires immediate medical attention.
Rare Diagnoses
- Cystic Fibrosis: A genetic disorder that affects the lungs, pancreas, and other organs, causing chronic respiratory symptoms, including coughing and wheezing.
- Immunodeficiency: Certain immunodeficiencies can predispose children to recurrent or severe respiratory infections, presenting with coughing and wheezing.
- Anaphylaxis: A severe, life-threatening allergic reaction that can cause respiratory symptoms, including coughing and wheezing, among other systemic symptoms.