What is the most likely diagnosis?

• 3 year-old with cough and fever

Frontal Chest Radiograph

1. Coarctation of the Aorta
2. Pectus Excavatum
3. Sarcoidosis
4. Cystic Fibrosis
5. Reactive Airways Disease/Bronchiolitis

Additional image - Close-up of Left Lower Lung

 

 

Additional Images

 

Close-up of Left Lower Lung

Answer:

 

5. Reactive Airways Disease/Bronchiolitis

 

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Reactive Airways Disease

 

General Considerations

• General term for a disease usually in the pediatric population featuring wheezing, shortness of breath and coughing
• Initial episodes are frequently referred to as bronchiolitis
• Unlike asthma, which is chronic, reactive airways disease is usually transient although it can progress over time to asthma
• May be triggered by
• Viral URIs, especially from respiratory syncytial virus (RSV)
• Pollen and mold
• Cigarette smoke
• Extreme cold
• Most (60%) of children who have wheezing before age 3 will outgrow it by age 6
• Use of the term is controversial, some believing it is too general

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