Clinico-pathologic conference: persistent tachypnea in a 5-week-old boy

The patient was a 5-week-old male admitted with tachypnea and increased respiratory: distress. Mother noted increased cough and increased work of breathing. There was no fever, congestion, or nasal discharge. Prior to presenting to the emergency room, he was given a bronchodilator nebulizer treatment at home with no improvement. Two weeks prior to the current admission, he was hospitalized in the pediatric intensive care unit for approximately two weeks for similar complaints. Physical examination on the current admission was significant for minimal nasal flaring and mild subcostal retractions, with intermittent oxygen requirement. Infectious workup was negative.