A 2-year-old boy presents to the emergency department with a 2-day history of tachypnea and cough. On arrival, vital signs demonstrate a temperature of 36.9 °C, respiratory rate of 38 breaths per minute, pulse of 148 beats per minute, blood pressure of 80/58 mmHg, and oxygen saturation of 92% on room air. Asymmetric breath sounds are noted on physical exam.

The history is negative for rhinorrhea, fever, drooling, dysphagia, or exposure to sick contacts. The child has no prior medical history of asthma or prematurity and had a normal newborn screen at birth.

A chest X-ray is performed.

What is the next best step after results of the chest X-ray are reviewed?

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Julia Meade, MD
Erika Friehling, MD MS

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