The Rational Clinical Examination
David L. Simel, Drummond Rennie
Pneumonia, Infant and Child
Daniel A. Ostrovsky, Anne Gadomski
pediatrics, pneumonia, work of breathing
"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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