Level 1: Dyspnea – Contrasting Case #1: Patient Information

Given these changes from the original case, what is your diagnosis?

What is your diagnostic explanation?

As compared to the long case, this patient is a 3-year-old boy who presents to the clinic with a 4-day history of shortness of breath and dry cough. His mother reports that he has had no rhinorrhea or other upper respiratory symptoms. He has not seemed fussy or nauseous, nor has he vomited. He has remained afebrile. He does not attend daycare, and there are no sick household contacts. His mother mentions that her older son, who has a large collection of Legos, has been perfectly healthy.

PE – On exam there are no abnormalities of the nasal turbinates and oropharynx. There is no sinus tenderness and no lymphadenopathy. There are absent breath sounds on auscultation over the right lower lobe; there is dullness to percussion over the same area. Faint wheezes may also be heard over the lower right lung field. The remainder of the exam is unremarkable.