National Board of Chiropractic Examiners (NBCE) Practice Test

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What is the most likely diagnosis for an afebrile child who has experienced persistent staccato paroxysmal cough for approximately 3 weeks?

  1. Asthma

  2. Bronchiolitis

  3. Pneumonia

  4. Chlamydia pneumoniae infection

The correct answer is: Chlamydia pneumoniae infection

The most likely diagnosis for an afebrile child experiencing a persistent staccato paroxysmal cough for approximately three weeks is related to Chlamydia pneumoniae infection. This type of infection is known for causing a distinctive cough that can present in a paroxysmal or staccato pattern, often without an accompanying fever. Chlamydia pneumoniae typically affects children and can lead to respiratory symptoms that last for several weeks. The absence of fever is also consistent with this diagnosis, as Chlamydia pneumoniae infections are less likely to cause high fever compared to other pneumonias caused by different pathogens. The staccato nature of the cough is a key feature that helps differentiate it from issues like asthma, bronchiolitis, or typical pneumonia, which usually present with different characteristics or accompanying symptoms. In contrast, asthma generally presents with wheezing and is often associated with a history of allergic conditions, while bronchiolitis is more common in infants and typically presents with respiratory distress and wheezing rather than a staccato cough. Pneumonia, depending on the causative agent, may manifest with fever and more systemic symptoms. Thus, the distinctive characteristics of the cough in conjunction with the presence of an afebrile condition