iHuman Case Study Week 4: 18-Month-Old with Cough — Pediatric Bronchiolitis SOAP Note & Assessment

I- HUMAN CASE STUDY WEEK 4 FOR AN 18-MONTH-
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OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM; W
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EIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE 2026
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Location: Outpatient pediatric clinic (lab and x-ray available)
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Reason for encounter
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Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems faster.
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”

,1. General Case Information v v




Case title & summary
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v18-month-
old toddler with 5 days of progressive cough, nasal congestion, decreased oral intake,
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vand nighttime worsening of cough. Case emphasizes pediatric respiratory illness eva
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luation (viral bronchiolitis, croup, pneumonia, pertussis, asthma/reactive airways), a
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ge-appropriate diagnostics, dosing, and safe outpatient vs inpatient management.
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Patient demographicsv




 Name: (Marvin? — patient is anonymized)
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 Age: 18 months v v


 Sex: Male (assume male unless otherwise specified)
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 Height: 86 cm (2'10") v v v


 Weight: 12.7 kg (28 lb) v v v v


 BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
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Case mode: Learning mode
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Case location: Outpatient pediatric clinic with point-of-care testing and imaging
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Attempts allowed: Unlimited v v




2. Chief Complaint (CC) v v




“My toddler has had a cough for five days and isn’t acting like himself —
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not eating much and breathing faster.”
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 Primary symptom: cough (day & night; worse at night)
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 Onset: 5 days ago v v v


 Course: progressively more frequent, occasional cough spells with slight p
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ost-tussive vomiting yesterday v v


 Associated: nasal congestion, low- v v v


grade fevers (parent measured 38.2°C once), decreased oral intake, less ac
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tive, brief periods of noisy breathing when upset
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 No known choking episode, no known foreign body ingestion
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, 3. History of Present Illness (HPI)
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 History: Previously healthy 18-month-old developed rhinorrhea and low-
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grade fever 5 days ago; cough began shortly after and has slowly increased. Pa
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rent reports cough is mostly dry but sometimes produces small amounts of clea
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r sputum. Nighttime cough is worse and causes multiple awakenings. Yesterda
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y had 1 episode of non-bloody, non-bilious post-
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tussive vomiting after prolonged coughing.
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 Feeding: Reduced intake of solids and fluids over the last 48 hours; fewer w
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et diapers (≈4 in 24 hrs vs usual 6–8).
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 Respiratory distress: Mild; parent notes faster breathing and “noisy” i
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nspiration when crying. No cyanosis seen. v v v v v


 Exposures: Attends daycare; multiple classmates with colds last week. No k
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nown TB or TB exposure. No recent travel. No pets causing concern. No par
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ental smoking in home. v v v


 Immunizations: Reported up-to- v v


date for age (DTaP, Hib, PCV, MMR/Var given at 12 months). Influenza vac
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cine status depends on season —
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vassume not yet given this season unless otherwise stated.
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 Previous episodes: No prior reactive airway disease or wheeze history. No
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NICU or chronic lung disease. v v v v


 Red flags denied: No choking episode, seizure, lethargy, neck stiffness, or p
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ersistent high fever. v v




4. Past Medical History (PMH)
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 Born full term, no NICU stay
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 No chronic medical conditions
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 No history of prematurity, congenital heart disease, cystic fibrosis, or r
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ecurrent pneumonias v


 Growth and development previously normal for age
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