A 3-month-old boy was referred to the pediatric department with respiratory problems. He has had a cough and runny nose for 2 days and has become progressively more chesty. He now has problems feeding, at least one episode of vomiting that may be a cough related and dry nappies. Older siblings in the family also have coryzal symptoms. The patient was born 2 weeks prematurely with no significant neonatal problems. The mother is on treatment for asthma and there is no other significant medical or family history.
Examination The initial examination showed a febrile infant with copious nasal secretions, conjunctivitis and noisy breathing (grunting and wheezing). There is tachypnoea (58 breaths per minute) with intercostal and subcostal retraction. On listening to the chest there are fine crackles and wheeze throughout. The rest of the examination is normal. Over the next 24 hours, the…
