I- HUMAN CASE STUDY WEEK 4 FOR AN 18-MONTH-
OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM;
WEIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE
2026
Location: Outpatient pediatric clinic (lab and x-ray available)
Reason for encounter
Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems
faster.”
,1. General Case Information
Case title & summary
18-month-old toddler with 5 days of progressive cough, nasal congestion,
decreased oral intake, and nighttime worsening of cough. Case emphasizes
pediatric respiratory illness evaluation (viral bronchiolitis, croup, pneumonia,
pertussis, asthma/reactive airways), age-appropriate diagnostics, dosing, and safe
outpatient vs inpatient management.
Patient demographics
• Name: (Marvin? — patient is anonymized)
• Age: 18 months
• Sex: Male (assume male unless otherwise specified)
• Height: 86 cm (2'10")
• Weight: 12.7 kg (28 lb)
• BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
Case mode: Learning mode
Case location: Outpatient pediatric clinic with point-of-care testing and imaging
Attempts allowed: Unlimited
2. Chief Complaint (CC)
“My toddler has had a cough for five days and isn’t acting like himself — not
eating much and breathing faster.”
• Primary symptom: cough (day & night; worse at night)
• Onset: 5 days ago
• Course: progressively more frequent, occasional cough spells with slight
post-tussive vomiting yesterday
• Associated: nasal congestion, low-grade fevers (parent measured 38.2°C
once), decreased oral intake, less active, brief periods of noisy breathing
when upset
• No known choking episode, no known foreign body ingestion
, 3. History of Present Illness (HPI)
• History: Previously healthy 18-month-old developed rhinorrhea and low-
grade fever 5 days ago; cough began shortly after and has slowly increased.
Parent reports cough is mostly dry but sometimes produces small amounts of
clear sputum. Nighttime cough is worse and causes multiple awakenings.
Yesterday had 1 episode of non-bloody, non-bilious post-tussive vomiting
after prolonged coughing.
• Feeding: Reduced intake of solids and fluids over the last 48 hours; fewer
wet diapers (≈4 in 24 hrs vs usual 6–8).
• Respiratory distress: Mild; parent notes faster breathing and “noisy”
inspiration when crying. No cyanosis seen.
• Exposures: Attends daycare; multiple classmates with colds last week. No
known TB or TB exposure. No recent travel. No pets causing concern. No
parental smoking in home.
• Immunizations: Reported up-to-date for age (DTaP, Hib, PCV, MMR/Var
given at 12 months). Influenza vaccine status depends on season — assume
not yet given this season unless otherwise stated.
• Previous episodes: No prior reactive airway disease or wheeze history. No
NICU or chronic lung disease.
• Red flags denied: No choking episode, seizure, lethargy, neck stiffness, or
persistent high fever.
4. Past Medical History (PMH)
• Born full term, no NICU stay
• No chronic medical conditions
• No history of prematurity, congenital heart disease, cystic fibrosis, or
recurrent pneumonias
• Growth and development previously normal for age
OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM;
WEIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE
2026
Location: Outpatient pediatric clinic (lab and x-ray available)
Reason for encounter
Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems
faster.”
,1. General Case Information
Case title & summary
18-month-old toddler with 5 days of progressive cough, nasal congestion,
decreased oral intake, and nighttime worsening of cough. Case emphasizes
pediatric respiratory illness evaluation (viral bronchiolitis, croup, pneumonia,
pertussis, asthma/reactive airways), age-appropriate diagnostics, dosing, and safe
outpatient vs inpatient management.
Patient demographics
• Name: (Marvin? — patient is anonymized)
• Age: 18 months
• Sex: Male (assume male unless otherwise specified)
• Height: 86 cm (2'10")
• Weight: 12.7 kg (28 lb)
• BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
Case mode: Learning mode
Case location: Outpatient pediatric clinic with point-of-care testing and imaging
Attempts allowed: Unlimited
2. Chief Complaint (CC)
“My toddler has had a cough for five days and isn’t acting like himself — not
eating much and breathing faster.”
• Primary symptom: cough (day & night; worse at night)
• Onset: 5 days ago
• Course: progressively more frequent, occasional cough spells with slight
post-tussive vomiting yesterday
• Associated: nasal congestion, low-grade fevers (parent measured 38.2°C
once), decreased oral intake, less active, brief periods of noisy breathing
when upset
• No known choking episode, no known foreign body ingestion
, 3. History of Present Illness (HPI)
• History: Previously healthy 18-month-old developed rhinorrhea and low-
grade fever 5 days ago; cough began shortly after and has slowly increased.
Parent reports cough is mostly dry but sometimes produces small amounts of
clear sputum. Nighttime cough is worse and causes multiple awakenings.
Yesterday had 1 episode of non-bloody, non-bilious post-tussive vomiting
after prolonged coughing.
• Feeding: Reduced intake of solids and fluids over the last 48 hours; fewer
wet diapers (≈4 in 24 hrs vs usual 6–8).
• Respiratory distress: Mild; parent notes faster breathing and “noisy”
inspiration when crying. No cyanosis seen.
• Exposures: Attends daycare; multiple classmates with colds last week. No
known TB or TB exposure. No recent travel. No pets causing concern. No
parental smoking in home.
• Immunizations: Reported up-to-date for age (DTaP, Hib, PCV, MMR/Var
given at 12 months). Influenza vaccine status depends on season — assume
not yet given this season unless otherwise stated.
• Previous episodes: No prior reactive airway disease or wheeze history. No
NICU or chronic lung disease.
• Red flags denied: No choking episode, seizure, lethargy, neck stiffness, or
persistent high fever.
4. Past Medical History (PMH)
• Born full term, no NICU stay
• No chronic medical conditions
• No history of prematurity, congenital heart disease, cystic fibrosis, or
recurrent pneumonias
• Growth and development previously normal for age
