Differential Diagnosis for Pediatric Shortness of Breath
Single Most Likely Diagnosis
- Viral upper respiratory infection (croup): This is a common cause of shortness of breath in pediatric patients, especially in those under the age of 5. The presentation often includes a barking cough, hoarseness, and difficulty breathing, which can be exacerbated at night.
Other Likely Diagnoses
- Pneumonia: Bacterial or viral pneumonia can cause shortness of breath, fever, and cough in pediatric patients. The diagnosis is often made based on clinical presentation and confirmed with a chest X-ray.
- Bronchiolitis: This is a common lower respiratory tract infection in infants and young children, caused by the respiratory syncytial virus (RSV). It presents with wheezing, cough, and shortness of breath.
- Foreign body aspiration: This is a common emergency in pediatric patients, especially in toddlers. The presentation can range from mild cough to severe respiratory distress, depending on the location and size of the foreign body.
Do Not Miss Diagnoses
- Epiglottitis: Although rare, epiglottitis is a life-threatening condition that requires prompt recognition and treatment. It presents with severe shortness of breath, stridor, and difficulty swallowing.
- Pneumothorax: A spontaneous pneumothorax can cause sudden onset of shortness of breath and chest pain. It is more common in tall, thin males, but can occur in any pediatric patient.
- Anaphylaxis: This is a severe, life-threatening allergic reaction that can cause shortness of breath, stridor, and respiratory failure. It requires immediate recognition and treatment with epinephrine.
Rare Diagnoses
- Congenital heart disease: Certain congenital heart defects can present with shortness of breath, especially if they involve left-to-right shunts or obstructive lesions.
- Cystic fibrosis: This is a genetic disorder that affects the respiratory and gastrointestinal systems, causing chronic respiratory infections and shortness of breath.
- Interstitial lung disease: This is a rare group of disorders that affect the lung parenchyma, causing shortness of breath, cough, and chest pain.