A two-year-old child with a history of meconium ileus presents with severe respiratory symptoms. What is a likely diagnosis?

The presence of a history of meconium ileus in a two-year-old child strongly points towards cystic fibrosis as the likely diagnosis. Meconium ileus often occurs in newborns with cystic fibrosis due to thick, sticky meconium that obstructs the intestine. Cystic fibrosis is a genetic disorder that affects the exocrine glands, leading to the production of thick mucus in various organs, primarily the lungs and digestive system.

In patients with cystic fibrosis, respiratory symptoms can be severe due to the accumulation of thick mucus in the airways, which can lead to obstructive lung disease, infections, and inflammatory responses. Symptoms commonly observed include chronic cough, wheezing, recurrent respiratory infections, and difficulty breathing.

Given these connections, the symptoms presented in the child align with the expected manifestations of cystic fibrosis, making it the most plausible diagnosis among the options provided.