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Not every cough in bronchiolitis season is bronchiolitis
Ronelle Vanessa Naidoo1, Penelope Ann Bryant
1St Georges Hospital, Paediatric Infectious Diseases, Blackshaw Road, Tooting, London SW17 0QT, UK.
BMJ Case Reports
|August 30, 2011
Summary
A 2-month-old infant with persistent respiratory symptoms was initially misdiagnosed with bronchiolitis. Further investigation revealed Chlamydia trachomatis as the cause, leading to successful treatment with azithromycin.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Infants can present with non-specific respiratory symptoms.
- Bronchiolitis is a common seasonal diagnosis in infants.
- Viral respiratory infections are frequent causes of infant respiratory distress.
Purpose of the Study:
- To investigate atypical causes of lower respiratory tract infection in an infant.
- To highlight the importance of considering non-viral pathogens in persistent infant respiratory illness.
- To report a case of Chlamydia trachomatis pneumonia in an infant.
Main Methods:
- Clinical presentation and history of a 2-month-old male infant.
- Diagnostic workup including nasopharyngeal aspirate (NPA) for viruses and C-reactive protein levels.
- Polymerase chain reaction (PCR) testing of NPA for atypical pathogens.
Main Results:
- Initial NPA for viruses was negative on multiple occasions.
- Infant presented with worsening cough, respiratory distress, crackles, and wheeze.
- NPA was positive for Chlamydia trachomatis by PCR.
Conclusions:
- Chlamydia trachomatis should be considered in the differential diagnosis of infant lower respiratory tract infections, especially when viral testing is negative.
- Prompt diagnosis and appropriate antibiotic treatment (azithromycin) lead to full recovery.
- This case underscores the limitations of relying solely on seasonal diagnoses and initial negative viral testing.
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