Jamie is a 1-year-old girl who is coughing and has had rhinorrhea with yellowish discharge for the past day. Her father says today he felt like she had a fever and has not been eating or playing; she has been mostly sleeping. Her 5-year-old sibling has had a cold for a week. 

  • Medications: none.
  • Allergies: no known drug allergies.
  • Vaccinations: up to date for age.
  • Social history: in day care; lives with mother, father, and 5-year-old sibling.
  • Physical examination: vital signs – temperature 101.5°F; pulse 120 beats per minute; respirations 34 per minute; blood pressure 100/60 mmHg; pulse oximeter 92%.
  • General: sitting in father’s lap; ill, lethargic appearance, and coughing.
  • HEENT: nasal flaring, nasal mucus yellowish bilaterally; oropharynx with mild erythema.
  • Neck: small anterior and posterior cervical nodes.
  • CV: unremarkable.
  • Lungs: intercostal retractions, expiratory wheezing.
  • Abdomen: unremarkable.

Answer the following questions or provide responses based on this scenario. 

  1. What is the most likely diagnosis and pathogen causing this disorder? Discuss the mode of transmission and discuss data that supports your decision.
  2. What diagnostic test, if any, should be done?
  3. Develop a treatment plan for this patient.