Match each classic pediatric respiratory clinical presentation (left) with its most likely causative microbiologic agent (right).
- An infant presents with bursts of rapid coughing followed by a high-pitched inspiration and post-tussive emesis, alongside marked lymphocytosis.Bordetella pertussis
- A toddler develops a harsh, seal-like cough and inspiratory stridor that worsens at night, with subglottic narrowing evident on radiography.Parainfluenza virus
- An unimmunized preschooler suddenly develops high fever, severe dysphagia, drooling, and assumes a tripod position to breathe.Haemophilus influenzae type b
- A young child presents with high fever, toxic appearance, and thick purulent tracheal secretions that do not improve with nebulized racemic epinephrine.Staphylococcus aureus
- A previously healthy infant develops copious clear rhinorrhea, low-grade fever, diffuse expiratory wheezing, and hyperinflated lungs on chest imaging.Respiratory syncytial virus
Answer
The presentations match as follows: paroxysmal cough with whoop is Bordetella pertussis; barking cough with stridor is Parainfluenza virus; drooling and tripod position is Haemophilus influenzae type b; purulent tracheal secretions is Staphylococcus aureus; and rhinorrhea with diffuse wheezing is Respiratory syncytial virus.
Each respiratory syndrome in the pediatric population has unique classic features: pertussis causes a whooping cough with severe lymphocytosis; croup presents with a barking cough and steeple sign due to parainfluenza; epiglottitis manifests with drooling and tripod positioning due to Hib; bacterial tracheitis presents as severe, refractory stridor with purulent secretions from S. aureus; and bronchiolitis causes diffuse wheezing and hyperinflation from RSV.
Step-by-Step Solution
Key Concept
Clinical presentation and microbiologic etiology of pediatric upper and lower respiratory tract infections.