Author: Ahmed Sakr, Ahmed Shahin / Editor: Stephen Sheridan / Codes: / Published: 06/11/2025
A 10-month-old boy is brought to the Emergency Department (ED) by his mother with a 3-day history of fever, cough, reduced feeding, and increased work of breathing. She reports no vomiting or diarrhoea but notes that he has been producing fewer wet nappies. He was recently admitted in Malta (his home country) for bronchiolitis for 2 days, two weeks ago. The family is currently on holiday in the UK. His immunizations are up to date.
On arrival, the infant appears alert but is crying continuously. Observations are within normal limits for his age, and PEWS is 0. Clinical examination reveals:
- A: Patient
- B: No crepitations or wheeze, Oxygen saturation 98% on room air
- C: capillary refill < 2 seconds
- D: alert, Crying
- E: No skin rashes, no fever
- H/N: No signs of tonsillitis or otitis media
His mother is concerned about his continuous crying over the past two days, which she says is very unusual for him.
