Respiratory Distress in a 2-Month-Old Infant with Family Viral Illness

Case at a Glance

A 2-month-old female infant presented with concerning respiratory symptoms including audible breathing and possible retractions in the setting of widespread viral illness affecting the entire household.

Patient's Story

The infant was born on May 5th, 2025, and was previously healthy with normal feeding patterns (combination breast and formula feeding), appropriate urine and stool output, and no fever. The patient's mother was currently taking Tylenol, ibuprofen, and had recently started Augmentin for a concurrent ear and sinus infection. The family resided in a rural area and had been significantly impacted by a viral illness affecting all household members.

Initial Assessment

At 1:30 AM, the attending nurse (infant's aunt, who had traveled to assist the family) noticed the infant was making audible sounds with each breath and observed what appeared to be mild intercostal retractions. The infant's lips and fingers showed normal coloration, indicating adequate oxygenation at the time of initial observation. Vital signs were stable with no documented fever.

The Diagnostic Journey

The family had recently experienced a severe viral outbreak. The mother had developed bilateral otitis media and bronchitis, while the 20-month-old sibling required two emergency department visits for croup-like symptoms and treatment with systemic corticosteroids. Testing for COVID-19, influenza, and RSV had returned negative results for affected family members. Of particular concern was the family's unvaccinated status against pertussis, raising suspicion for possible whooping cough transmission to the vulnerable newborn.

Final Diagnosis

Respiratory distress in a newborn secondary to viral upper respiratory infection with intercostal retractions requiring immediate medical evaluation.

Treatment Plan

The infant was transported to the pediatric emergency department for immediate evaluation and management. The medical team emphasized the critical importance of ensuring all household contacts receive appropriate vaccinations, particularly pertussis vaccination, to protect the vulnerable infant.

Outcome and Follow-up

The family followed the recommendation for immediate emergency department evaluation. The case highlights the importance of recognizing early signs of respiratory distress in newborns and the critical role of herd immunity through vaccination in protecting vulnerable populations.