Case study ( 2725 views as of March 23, 2019 )
Damon is a 15-month-old male who has had a cold almost continuously since he was 8 months old. He has a 3-year-old sister, and he spends 4 days a week in daycare, which his father refers to as the 'snot factory'. He is brought into the local walk-in clinic about twice a month when he gets a fever, or if his cough seems worse. He has been put on antibiotics a few times, but his mom is frustrated, as some doctors say "it's viral", and others just write a prescription. He was taken to the emergency department once with his symptoms, and they gave him a mask treatment with misted medications, and did a chest x-ray. Damon's parents were told he had "no pneumonia" and that it was "just viral", and discharged with a recommendation to take Tylenol if needed.
In the last 24 hours, Damon has had two low-grade fevers, and his cough seems to be worsening again. One of the other moms from daycare points out that he "probably has asthma...you should get him checked".
Damon would benefit from seeing a consistent primary care provider, who can monitor and reassess him over time. Virally triggered respiratory distress is very common in this age group, and may lead to a variety of diagnoses being proposed, including bronchiolitis, bronchitis, asthma, cold, chest cold, upper respiratory tract infection (URTI), and/or lower respiratory tract infection (LRTI). Sometimes it gets called a "flu-like illness".Author: Dr. Adam Lund