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- Beth D. Harper, MD*
- *Boston Children's Hospital, Boston, MA
AUTHOR DISCLOSURE
Dr Harper has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Presentation
A 4-month-old girl presents with a 1-week history of a temperature to 102°F (38.9°C), congestion, rhinorrhea, and cough. She has had fatigue and diaphoresis with feedings over the last week, although this did not occur before this time. She was born at term following normal findings on prenatal ultrasonography. Initially, she had difficulty gaining weight, but she is now growing along the 10th percentile. She had 1 overnight hospitalization for bronchiolitis at age 2 months and was treated with albuterol for a total of 1 week. Her mother has a history of asthma in childhood.
On physical examination, the girl is febrile and has a heart rate of 150 beats/min, respiratory rate of 46 breaths/min, and intercostal and subcostal retractions. Chest auscultation reveals bilateral coarse breath sounds. A rapid respiratory syncytial virus (RSV) antigen test is positive, and she is admitted to the inpatient ward. She remains tachycardic, with an increased heart rate to …
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