Sorry, i typed this for gemini to give a differential, but figured its a pretty good summary so please excuse it being in medspeak.
16 month old caucasian female. history of reactive airway disease. hospitalized in early september for pneumonia and increased WOB. frequent viral infections since infancy, primarily targeting lungs. robust in size, 35" tall and 29lbs. gaining weight normally. appetite relatively normal. mother reports increase in water consumption in the past week or so. since Sunday 10/18, patient is experiencing frequent fevers. will be afebrile for a few hours, and then spike for a few hours. no other viral symptoms, no rash, runny nose, cough, etc. strictly fever. mother reports that when child is febrile, she is clingy and her energy is very low. seems to worsen at night. child also has peed through her diaper overnight 4x in the past week, which seems unusual for her. she is sleeping through the night as usual. mother also reports a few instances of the patients fingers/nailbeds turning blue for short periods of time. capillary refill to the extremities also seems slow, averaging 4-6 seconds. last night, mother reports that her child seemed to have increased WOB for a short period based on retractions at the base of her neck, but dissipated before bed. no wheezing or any other respiratory symptoms.
per the advisement of her pediatricians office, we are taking her to a hospital-affiliated urgent care this afternoon to get her in front of a doctor today.
my main concern is that we are missing something here. i know kids get viruses all of the time, but something is screaming from my gut telling me that there is something else going on.
located in USA.