Abstract
BACKGROUND: We report a 1-month-old infant admitted with fever, dyspnea, and desaturation after an unmonitored pregnancy in a migrant family. The patient rapidly required mechanical ventilation. Laboratory parameters were markedly elevated, suggesting an infectious etiology. METHODS: The clinical course is described with emphasis on diagnostic challenges, including imaging, laboratory findings, and the stepwise process of differential diagnosis. RESULTS: After common etiologies were excluded, rarer causes were considered. The final diagnosis was established through integration of clinical assessment, radiological imaging, laboratory data, and microbiological testing. CONCLUSION: In neonates with fever and respiratory distress, RSV bronchiolitis is usually the first consideration. If excluded, clinicians must remain alert to less frequent etiologies. This case underscores the importance of a broad differential diagnosis in infants with acute respiratory compromise.