infectious disease/bacterial

Lab Parameter	Value	Reference Range
White Blood Cell Count	14.5 x 10^9/L	4.5-11.0 x 10^9/L
Neutrophils	75%	40-70%
C-reactive protein	45 mg/L	< 5 mg/L

Lab Parameter

Value

Reference Range

White Blood Cell Count

14.5 x 10^9/L

4.5-11.0 x 10^9/L

Neutrophils

75%

40-70%

C-reactive protein

45 mg/L

< 5 mg/L

See Explanation

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Question 2 / 2

686463876c78b8d82816dce2

Pediatrics

infectious disease

bacterial

Case History

A 4-year-old girl is brought to the emergency department by her parents due to severe breathing difficulties. Her mother reports a 5-day history of a low-grade fever and a "barky cough" that began last week. She was seen at an urgent care center 3 days ago, received a nebulized treatment and a prescription for oral corticosteroids, and was discharged. Despite compliance with the medication, her condition has progressively worsened, leading to increasing respiratory effort and noticeable stridor, prompting this visit. Her past medical history is unremarkable, and her immunizations are up-to-date. On examination, the child appears lethargic and distressed, with signs of significant work of breathing, including intercostal retractions and nasal flaring. Her temperature is 39.2 °C. Her oropharynx is clear, without erythema or exudates. You observe prominent inspiratory and expiratory stridor. Her heart rate is 145 bpm, respiratory rate is 48 breaths/min, and SpO2 is 88% on room air. What is the most likely diagnosis and the immediate definitive management strategy?

Lab Parameter	Value	Reference Range
White Blood Cell Count	18.5 x 10^9/L	4.5-13.5 x 10^9/L
Neutrophils	80%	40-60%
C-reactive protein	125 mg/L	<5 mg/L

A ) Viral Croup (Laryngotracheobronchitis) and continued oral dexamethasone with nebulized budesonide.

B ) Acute Epiglottitis and urgent direct laryngoscopy in the operating room for definitive airway management.

C ) Peritonsillar Abscess and urgent incision and drainage with intravenous antibiotics.

D ) Bacterial Tracheitis and urgent endotracheal intubation in a controlled setting with initiation of broad-spectrum intravenous antibiotics.

E ) Foreign Body Aspiration and emergent rigid bronchoscopy.

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