8-MONTH- OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM; WEIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE 2026

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
g; g;


Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems
g; g; g; g; g; g; g; g; g; g; g; g;


faster.”
g;

,1. General Case Information g; g;




Case title & summary
g; g; g;


18-month-old toddler with 5 days of progressive cough, nasal congestion,
g; g; g; g; g; g; g; g; g;


decreased oral intake, and nighttime worsening of cough. Case emphasizes
g; g; g; g; g; g; g; g; g; g;


pediatric respiratory illness evaluation (viral bronchiolitis, croup, pneumonia,
g; g; g; g; g; g; g; g;


pertussis, asthma/reactive airways), age-appropriate diagnostics, dosing, and safe
g; g; g; g; g; g; g; g;


outpatient vs inpatient management.
g; g; g; g;




Patient demographicsg;




• Name: (Marvin? — patient is anonymized)
g; g; g; g; g;


• Age: 18 months g; g;


• Sex: Male (assume male unless otherwise specified)
g; g; g; g; g; g;


• Height: 86 cm (2'10") g; g; g;


• Weight: 12.7 kg (28 lb) g; g; g; g;


• BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
g; g; g; g; g; g; g; g;




Case mode: Learning mode
g; g; g;


Case location: Outpatient pediatric clinic with point-of-care testing and imaging
g; g; g; g; g; g; g; g; g;


Attempts allowed: Unlimited g; g;




2. Chief Complaint (CC) g; g;




“My toddler has had a cough for five days and isn’t acting like himself — not
g; g; g; g; g; g; g; g; g; g; g; g; g; g; g;


eating much and breathing faster.”
g; g; g; g; g;




• Primary symptom: cough (day & night; worse at night)
g; g; g; g; g; g; g; g;


• Onset: 5 days ago g; g; g;


• Course: progressively more frequent, occasional cough spells with
g; g; g; g; g; g; g;


slight post-tussive vomiting yesterday
g; g; g; g;


• Associated: nasal congestion, low-grade fevers (parent measured g; g; g; g; g; g;


38.2°C once), decreased oral intake, less active, brief periods of
g; g; g; g; g; g; g; g; g; g;


noisy breathing when upset
g; g; g; g;


• No known choking episode, no known foreign body ingestion
g; g; g; g; g; g; g; g;

, 3. History of Present Illness (HPI)
g; g; g; g;




• History: Previously healthy 18-month-old developed rhinorrhea and low-
g; g; g; g; g; g; g;


grade fever 5 days ago; cough began shortly after and has slowly
g; g; g; g; g; g; g; g; g; g; g; g;


increased. Parent reports cough is mostly dry but sometimes produces
g; g; g; g; g; g; g; g; g; g;


small amounts of clear sputum. Nighttime cough is worse and causes
g; g; g; g; g; g; g; g; g; g; g;


multiple awakenings. Yesterday had 1 episode of non-bloody, non-
g; g; g; g; g; g; g; g; g;


bilious post-tussive vomiting after prolonged coughing.
g; g; g; g; g;


• Feeding: Reduced intake of solids and fluids over the last 48 hours;
g; g; g; g; g; g; g; g; g; g; g;


fewer wet diapers (≈4 in 24 hrs vs usual 6–8).
g; g; g; g; g; g; g; g; g; g;


• Respiratory distress: Mild; parent notes faster breathing and g; g; g; g; g; g; g;


“noisy” inspiration when crying. No cyanosis seen.
g; g; g; g; g; g; g;


• Exposures: Attends daycare; multiple classmates with colds last week.
g; g; g; g; g; g; g; g;


No known TB or TB exposure. No recent travel. No pets causing
g; g; g; g; g; g; g; g; g; g; g; g;


concern. No parental smoking in home.
g; g; g; g; g; g;


• Immunizations: Reported up-to-date for age (DTaP, Hib, PCV, g; g; g; g; g; g; g;


MMR/Var given at 12 months). Influenza vaccine status depends on
g; g; g; g; g; g; g; g; g; g;


season — assume not yet given this season unless otherwise stated.
g; g; g; g; g; g; g; g; g; g; g;


• Previous episodes: No prior reactive airway disease or wheeze history.
g; g; g; g; g; g; g; g; g;


No NICU or chronic lung disease.
g; g; g; g; g; g;


• Red flags denied: No choking episode, seizure, lethargy, neck stiffness,
g; g; g; g; g; g; g; g; g;


or persistent high fever.
g; g; g; g;




4. Past Medical History (PMH)
g; g; g;




• Born full term, no NICU stay
g; g; g; g; g;


• No chronic medical conditions
g; g; g;


• No history of prematurity, congenital heart disease, cystic fibrosis,
g; g; g; g; g; g; g; g;


or recurrent pneumonias
g; g; g;


• Growth and development previously normal for age
g; g; g; g; g; g;