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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Pneumonia, Infant and Child
Daniel A. Ostrovsky, Anne Gadomski
Clinical Scenario


Topics Discussed: pediatrics, pneumonia, work of breathing

Excerpt: "A 15-month-old child is brought to your office in May. She had been "breathing heavy" the previous day. She was well until about 2 days ago, when she developed nasal congestion with clear rhinorrhea, cough, and a low-grade fever. Your review shows this child had a normal birth history, demonstrated normal growth and development, and has not had any significant respiratory infections or reactive airway disease. On examination, you find a temperature of 38.2°C and a respiratory rate of 45/min. She has clear rhinorrhea and mild subcostal retractions but no abnormal lung sounds on auscultation. ..."
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