Shelby, is a 4 week old, and presents to your office in mid…
Shelby, is a 4 week old, and presents to your office in mid January with a one week history of nasal congestion and occasional cough. On the evening prior to this visit Shelby developed a temperature of 102F, refused to breast feed; had paroxysmal coughing and noisy labored breathing. On exam, you note an ill appearing infant who is lethargic with tachypnea and intercostal retractions. Shelby does not attend daycare but has a 3 year old sibling who is in day care and who recently had a “cold”. Considering the clinical presentation, what is the most likely cause of Shelby’s illness?