Question

Patient: 3 year old child presenting with a 4-day history of fevers. He became acutely ill and vomited during lunch (not from bad food). Over the next 4 days, he developed fevers as high as 104˚ F that were controlled by Tylenol. He also developed cough, rhinorrhea and conjunctivitis. He appeared to be fatigued and parents reported that he was “very sleepy”. Over the past 2 days, his eyes had begun to itch and were painful. His parents noted that his eyes were puffy and he was sensitive to light. He had had no rashes. The child’s lips were dried and cracked and greatly reduced urinary output.

He had attended preschool twice per week where there were multiple sick contacts. His illness occurred in late January. His 1 year old sibling had otitis media, some wheezing, vomiting and a productive cough.

1. Laboratory findings were normal. A nasopharyngeal swab was collected and tested for (select the one most likely test(s) to be done….remember, this is a virology course):

1. Bordetella pertussis
2. Influenza A & B
3. RSV
4. Rhinovirus
5. 2 & 3
6. 1 & 4
7. What do think the results of the test(s) were (Positive for which, if any)?
8. His symptoms were consistent with which illness?
9. What is the typical outcome of this infection?
10. How do think the patient became infected?

Answer 1

The test has more chance to be positive for RSV. It is a contagious disease that affects babies in the winter season. It interferes with the respiratory system and develops various symptoms. It usually occurs in young children.

What do think the results of the test(s) were (Positive for which, if any)?

RSV spread through droplet infection. He may have weakened immune system and his brother already having otitis media, productive cough, and sneezing so he can easily get infected with RSV.

His symptoms were consistent with which illness?

His symptoms of high-grade fever 104 F, rhinorrhea, conjunctivitis, cough, and signs of dehydration(cracked lips, decreased urine output) are consistent with the respiratory syncytial virus.

What is the typical outcome of this infection?

The children usually can recover from infection with proper management and treatment. If the babies develop serious infection, then need to be hospitalized and to be treated properly.

How do think the patient became infected?

The symptoms of eye puffiness, irritation, sensitive to light show that the baby gets infected.